Individual provider Active NPI

Keven L Deeter, CRNA

  • Certified Registered Nurse Anesthetist
  • Milan, OH
National Provider Identifier
1144559956
Registry record updated May 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11030 Issued in OH
Practice address
2114 State Route 113 E
Milan, OH 44846-9483
Phone
(419) 499-4500
Fax
(419) 499-1219
NPI assigned
Dec 8, 2009
Last updated
May 24, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2010

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 11030 OH Primary

Addresses

Primary practice location

2114 State Route 113 E
Milan, OH 44846-9483

Mailing address

2114 State Route 113 E
Milan, OH 44846-9483
Phone (419) 499-4500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100513000193 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638207566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Firelands Anesthesia Associates IncGroup PAC ID 9032143334, 6 clinicians

Practice addresses (Care Compare)

1100 Neal Zick Rd
Willard, OH 44890-9287
Phone (419) 964-5479

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11030OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Firelands Anesthesia Associates, Inc Nurse Anesthetist, Certified Registered CurrentSince Oct 22, 2018 Accepting new patients
Crna of Blanchard Valley LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1100 Neal Zick Rd
Willard, OH 44890
Phone (419) 933-2811

Organizations & group practices 2

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1144559956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 STATE ROUTE 113 E",
            "city": "MILAN",
            "state": "OH",
            "postal_code": "448469483",
            "telephone_number": "419-499-4500",
            "fax_number": "419-499-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 STATE ROUTE 113 E",
            "city": "MILAN",
            "state": "OH",
            "postal_code": "448469483",
            "telephone_number": "419-499-4500",
            "fax_number": "419-499-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEETER",
        "first_name": "KEVEN",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-08",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "11030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milan, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; 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.