Individual provider Active NPI

Lucas Halliday

  • Certified Registered Nurse Anesthetist
  • Zanesville, OH
National Provider Identifier
1154072866
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0020432 Issued in OH
Practice address
2951 Maple Ave
Zanesville, OH 43701-1406
Phone
(740) 454-5000
NPI assigned
Jan 13, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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 0020432 OH Primary

Addresses

Primary practice location

2951 Maple Ave
Zanesville, OH 43701-1406

Mailing address

20715 Berry Rd
Mount Vernon, OH 43050-9226

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lhalliday34063@lickingmemorial.medicity.net Licking Memorial Health Professionals

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220204001138 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981097474 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Anesthesia Providers, LLCGroup PAC ID 0042558066, 54 clinicians

Practice addresses (Care Compare)

2951 Maple Ave
Zanesville, OH 43701-1406
Phone (740) 454-5000

Hospital & facility affiliations

  • Genesis Hospital Hospital, Zanesville, OH, CCN 360039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0020432OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Anesthesia Providers, LLC CurrentSince Dec 27, 2021 Accepting new patients
Licking Memorial Professional Corporation CurrentSince Jul 7, 2023 Accepting new patients
Licking Memorial Health Professionals CurrentSince Jul 7, 2023 Accepting new patients

Locations

1320 W Main St
Newark, OH 43055
Phone (740) 348-4151

120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806

2907 Bell St
Zanesville, OH 43701
Phone (740) 455-6300

2951 Maple Ave
Zanesville, OH 43701
Phone (740) 454-4000

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.

Hospital & facility affiliations 4

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": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1154072866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20715 BERRY RD",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430509226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2951 MAPLE AVE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437011406",
            "telephone_number": "740-454-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLIDAY",
        "first_name": "LUCAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-13",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "0020432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lhalliday34063@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "affiliationName": "Licking Memorial Health Professionals",
            "address_1": "2951 Maple Ave",
            "city": "Zanesville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "437011406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.