Individual provider Active NPI

Glenn Luther, CRNA

  • Certified Registered Nurse Anesthetist
  • Toledo, OH
National Provider Identifier
1174576482
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
COA.00404-NA Issued in OH
Practice address
2409 Cherry St
#305
Toledo, OH 43608
Phone
(419) 251-3740
Fax
(419) 251-3859
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 199055 OH
Certified Registered Nurse Anesthetist 367500000X COA.00404-NA OH Primary

Addresses

Primary practice location

2409 Cherry St
#305
Toledo, OH 43608

Mailing address

4342 Tamworth Rd
Sylvania, OH 43560-3813

Other identifiers 1

IdentifierTypeStateIssuer
0775577MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060125000656 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 1759305014 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Albany Medical College of Union University, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Anesthesia Providers LLCGroup PAC ID 2567682073, 7 clinicians
Southwest Ohio Anesthesia Consultants LLCGroup PAC ID 6901700640, 362 clinicians

Practice addresses (Care Compare)

725 S Shoop Ave
Wauseon, OH 43567-1702
Phone (419) 335-2015

7500 State Rd
Cincinnati, OH 45255-2439
Phone (513) 624-4500

Hospital & facility affiliations

  • Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112
  • Fulton County Health Center Hospital, Wauseon, OH, CCN 361333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
199055OHMDSpecialist
COA.00404-NAOHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 14, 2023 Accepting new patients
Southwest Ohio Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 14, 2022 Accepting new patients
Northstar Anesthesia of Ohio LLC CurrentSince Jun 1, 2015 Accepting new patients
Southwest Ohio Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 14, 2022 Accepting new patients

Locations

3000 Hospital Dr
Batavia, OH 45103
Phone (513) 557-3209

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

L3856
Columbus, OH 43260

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

2213 Cherry St
Toledo, OH 43608
Phone (419) 251-4283

725 S Shoop Ave
Wauseon, OH 43567
Phone (419) 335-2015

Organizations & group practices 4

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 2

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430352000000",
    "number": "1174576482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4342 TAMWORTH RD",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435603813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 CHERRY ST",
            "address_2": "#305",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43608",
            "telephone_number": "419-251-3740",
            "fax_number": "419-251-3859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTHER",
        "first_name": "GLENN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2015-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "199055",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.00404-NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0775577",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; 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.