Richard E Pack, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

NA-01763 Issued in OH

Practice address

1995 E State St
Salem, OH 44460-2423

Phone

(330) 332-1551

Fax

(330) 332-7663

NPI assigned

May 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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.

• Advanced Anesthesia Associates,Inc

  • Anesthesiology Physician
  • Youngstown, OH
  • NPI 1538117460
  NPD (past)
• Associates in Anesthesiology, Inc

  • Specialist
  • Youngstown, OH
  • NPI 1346234044
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1154377331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3622 BELMONT AVE",
            "address_2": "SUITE 1",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051450",
            "telephone_number": "330-759-9350",
            "fax_number": "330-759-9387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 E STATE ST",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444602423",
            "telephone_number": "330-332-1551",
            "fax_number": "330-332-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "RICHARD",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN-114377331",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "NA-01763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0748025",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Orion Blossom LLC
• Orion Blossom LLC
• Orion Blossom LLC
• Michael F Orosz Jr., BSN RN
• Madeleine Ana Ortiz, M.D.
• Morgan Pallo, M.ED, ED.S.
• Rebecca Anne Palmer, DC
• Pamela D. Drake, M.D., P.a., Co.
• Victoria M Paolucci
• Troy Pascley, QMHS-B

• Certified Registered Nurse Anesthetist in Salem, OH
• Providers in Salem, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; 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.