Individual provider Active NPI

Katie E Duracky, CRNA

  • Certified Registered Nurse Anesthetist
  • Toledo, OH
National Provider Identifier
1184067118
Registry record updated Aug 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
COA.14184-NA Issued in OH
Practice address
3000 Arlington Ave
Toledo, OH 43614-2595
Phone
(419) 383-3556
Fax
(419) 383-3550
NPI assigned
Apr 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2017

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.14184-NA OH Primary

Addresses

Primary practice location

3000 Arlington Ave
Toledo, OH 43614-2595

Mailing address

3355 Glendale Ave 3Rd FL
Toledo, OH 43614-2426
Phone (419) 383-5322

Other identifiers 2

IdentifierTypeStateIssuer
0084747MedicaidOH
COA.14184-NAOtherOHLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130528000234 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658519921 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.14184-NAOHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Ohio Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2022 Accepting new patients
A4 of Ohio, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2019 Accepting new patients
Promedica Central Physicians CurrentSince Nov 1, 2024 Accepting new patients
Northstar Anesthesia of Ohio LLC CurrentSince Jul 30, 2018 Accepting new patients
Promedica Central Physicians CurrentSince Nov 1, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Ohio Anesthesia Group, Inc Nurse Anesthetist, Certified Registered PastSince Jun 1, 2016 Accepting new patients

Locations

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

5959 Monclova Rd
Maumee, OH 43537
Phone (419) 251-3740

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

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

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

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

3000 Arlington Ave
Toledo, OH 43614
Phone (419) 383-3556

Organizations & group practices 7

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 1

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": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503619200000",
    "number": "1184067118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 GLENDALE AVE 3RD FL",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142426",
            "telephone_number": "419-383-5322",
            "fax_number": "419-383-6235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ARLINGTON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142595",
            "telephone_number": "419-383-3556",
            "fax_number": "419-383-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURACKY",
        "first_name": "KATIE",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2017-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.14184-NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0084747",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "COA.14184-NA",
            "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 Aug 25, 2017; 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.