NPIMap

Organization Active NPI

Fayette Anesthesia Services, Inc.

  • Certified Registered Nurse Anesthetist
  • Wilmington, OH
National Provider Identifier
1104818079
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
FAYETTE ANESTHESIA SERVICES, INC.
Practice address
1150 W Locust St
Suite 200
Wilmington, OH 45177-2572
Phone
(937) 383-0088
Fax
(937) 382-4654
NPI assigned
Aug 17, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Richard Swensen, CRNA
Title
President
Phone
(740) 606-0630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

1150 W Locust St
Suite 200
Wilmington, OH 45177-2572

Mailing address

PO Box 153
Germantown, OH 45327-0153
Phone (717) 263-5562

Other identifiers 1

IdentifierTypeStateIssuer
2299123MedicaidOH

National Provider Directory

National Provider Directory

Locations

Dept L3222
Columbus, OH 43260

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1104818079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 153",
            "city": "GERMANTOWN",
            "state": "OH",
            "postal_code": "453270153",
            "telephone_number": "717-263-5562",
            "fax_number": "717-263-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 W LOCUST ST",
            "address_2": "SUITE 200",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772572",
            "telephone_number": "937-383-0088",
            "fax_number": "937-382-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTE ANESTHESIA SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-17",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "SWENSEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "740-606-0630",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2299123",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.