Individual provider Active NPI

Charlene S White-Lowery, CRNA

  • Certified Registered Nurse Anesthetist
  • Warren, OH
National Provider Identifier
1154691491
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
COA.14123-NA Issued in OH
Practice address
1622 E Market St
Warren, OH 44483-6613
Phone
(330) 399-7215
NPI assigned
Jan 4, 2012
Last updated
Jun 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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 COA.14123-NA OH Primary

Addresses

Primary practice location

1622 E Market St
Warren, OH 44483-6613

Mailing address

1622 E Market St
Warren, OH 44483-6613
Phone (330) 399-7215

Other identifiers 4

IdentifierTypeStateIssuer
PENDINGOtherOHMEDICARE PTAN
PENDINGOtherOHANTHEM BCBS
PENDINGOtherOHMEDICARE RAILROAD
PENDINGMedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120126000257 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981871381 Reassigns benefits to 1 organization
I20150501000791 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981871381 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Gastroenterology Clinic and Endoscopy Center IncGroup PAC ID 3274429477, 36 clinicians

Practice addresses (Care Compare)

1622 E Market St
Warren, OH 44483-6613
Phone (330) 399-7215

949 N Hermitage Rd
Hermitage Gastroenterology Group Inc
Hermitage, PA 16148-3219
Phone (330) 399-7215

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.14123-NAOHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Ohio LLC CurrentSince Mar 22, 2015 Accepting new patients
Bel-Park Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered CurrentSince Sep 28, 2015 Accepting new patients
The Gastroenterology Clinic & Endoscopy Center Inc CurrentSince Jul 1, 2016 Accepting new patients
Penn-Ohio Associates in Anesthesiology, LLC Past Accepting new patients
Melius Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

4135 Boardman Canfield Rd
Ste 101
Canfield, OH 44406
Phone (330) 532-7215

2615 E High St
Springfield, OH 45505
Phone (888) 861-3994

1622 E Market St
Warren, OH 44483
Phone (330) 399-7215

667 Eastland Ave SE
Warren, OH 44484
Phone (330) 841-2378

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

949 N Hermitage Rd
Hermitage, PA 16148
Phone (330) 399-7215

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1154691491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444836613",
            "telephone_number": "330-399-7215",
            "fax_number": "330-399-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444836613",
            "telephone_number": "330-399-7215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE-LOWERY",
        "first_name": "CHARLENE",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-04",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.14123-NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "PENDING",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "PENDING",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "PENDING",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.