Broc Nichelson

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN.CRNA.16984 Issued in OH

Practice address

2142 N Cove Blvd
Toledo, OH 43606-3895

Phone

(419) 291-4491

Fax

(419) 479-6905

NPI assigned

Jan 26, 2015

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

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Southwest Ohio Anesthesia Consultants LLCGroup PAC ID 6901700640, 362 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health - Defiance Hospital Hospital, Defiance, OH, CCN 360270
• Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Promedica Central Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1043270150
  Medicare reassignment Care Compare group NPD
• Southwest Ohio Anesthesia Consultants LLC

  • Anesthesiology Physician
  • Cincinnati, OH
  • NPI 1588645188

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Northern Anesthesia Providers, LLC

  • Certified Registered Nurse Anesthetist
  • Wauseon, OH
  • NPI 1821498650

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Ohio Anesthesia Group, Inc

  • Anesthesiology Physician
  • Canton, OH
  • NPI 1639348113

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Promedica Central Physicians

  dba ProMedica Physicians Durable Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • Toledo, OH
  • NPI 1669068482
  NPD
• Southwest Ohio Anesthesia Consultants LLC

  • Anesthesiology Physician
  • Cincinnati, OH
  • NPI 1255768107

  Nurse Anesthetist, Certified Registered

  NPD

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

• Mercy Health - Defiance Hospital LLC

  dba Mercy Health - Defiance Hospital

  • General Acute Care Hospital
  • Defiance, OH
  • NPI 1629011234
  Care Compare affiliation
• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Care Compare affiliation
• Toledo Hospital

  dba ProMedica Transportation Network

  • Ambulance
  • Toledo, OH
  • NPI 1427147339

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1154711497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST FL 7",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531",
            "fax_number": "419-824-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 N COVE BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063895",
            "telephone_number": "419-291-4491",
            "fax_number": "419-479-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHELSON",
        "first_name": "BROC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-26",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.16984",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "16984-NA",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leena Nguyen, RPH
• Quendolynn Hang Nguyen, R.PH
• Vy Tran Thao Nguyen
• NH Care Collaborative LLC (Toledo Clinic, Inc.)
• Ghassan Niaz
• Selena Cara Nicholas-Bublick, M.D., M.H.S
• Kristan Edward Nicholas, DDS
• Mary Nicholls
• Caitlyn Nicole Nichols, PCPNP
• Faith Nichols

• Certified Registered Nurse Anesthetist in Toledo, OH
• Providers in Toledo, 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 Apr 5, 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.