Individual provider Active NPI

Glenn A Buller, CRNA

  • Certified Registered Nurse Anesthetist
  • Piqua, OH
National Provider Identifier
1124056965
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN-177640 Issued in OH
Practice address
283 Looney Rd
Piqua, OH 45356-4147
Phone
(888) 738-2841
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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-177640 OH Primary

Addresses

Primary practice location

283 Looney Rd
Piqua, OH 45356-4147

Mailing address

PO Box 2429
Murrells Inlet, SC 29576-2429
Phone (843) 651-2624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN-177640OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Consolidated Anesthesiologists Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Associates of Lima Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Eastside Anesthesia Group Nurse Anesthetist, Certified Registered Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 4

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124056965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2429",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295762429",
            "telephone_number": "843-651-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 LOONEY RD",
            "city": "PIQUA",
            "state": "OH",
            "postal_code": "453564147",
            "telephone_number": "888-738-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLER",
        "first_name": "GLENN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN-177640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Piqua, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.