Individual provider Active NPI

Jeri Andrus, CRNA

  • Certified Registered Nurse Anesthetist
  • Akron, OH
National Provider Identifier
1124024484
Registry record updated Mar 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN.259953 Issued in OH
Practice address
400 Wabash Ave
Akron, OH 44307-2433
Phone
(330) 344-6000
NPI assigned
Jun 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN.259953 OH Primary

Addresses

Primary practice location

400 Wabash Ave
Akron, OH 44307-2433

Mailing address

224 W Exchange St
Ste 360
Akron, OH 44302-1715
Phone (330) 344-6401

Other identifiers 3

IdentifierTypeStateIssuer
2071636MedicaidOH
000000221850OtherOHANTHEM PIN#
430058352OtherOHTRAVELERS PIN#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040317000076 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911897749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nye Eye Anesthesia IncGroup PAC ID 0547508624, 9 clinicians

Practice addresses (Care Compare)

1320 Lake Roger Dr
Kent, OH 44240-6250
Phone (360) 667-3075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.259953OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Nye Eye Anesthesia Inc Nurse Anesthetist, Certified Registered CurrentSince Dec 8, 2018 Accepting new patients
Hollywood Diagnostic Center Inc Past Accepting new patients
Anesthesiology Associates of Akron, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1124024484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 W EXCHANGE ST",
            "address_2": "STE 360",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443021715",
            "telephone_number": "330-344-6401",
            "fax_number": "330-344-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WABASH AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443072433",
            "telephone_number": "330-344-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRUS",
        "first_name": "JERI",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN.259953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2071636",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN#",
            "identifier": "000000221850",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS PIN#",
            "identifier": "430058352",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.