Individual provider Active NPI

Jodie Vincent Hartzell, CRNA

  • Certified Registered Nurse Anesthetist
  • Steubenville, OH
National Provider Identifier
1265405054
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.08149 Issued in OH
Practice address
4000 Johnson Rd
Steubenville, OH 43952-2300
Phone
(740) 264-8000
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN352146L PA
Certified Registered Nurse Anesthetist 367500000X APRN.CRNA.08149 OH Primary

Addresses

Primary practice location

4000 Johnson Rd
Steubenville, OH 43952-2300

Mailing address

115 Woodland Park
Wintersville, OH 43953-3855

Other identifiers 2

IdentifierTypeStateIssuer
101171560MedicaidPA
2173964MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120502000581 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608813316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weirton Medical Center IncGroup PAC ID 6709771827, 23 clinicians

Practice addresses (Care Compare)

601 Colliers Way
Weirton, WV 26062-5014
Phone (304) 797-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CRNA.08149OHMDCertified Registered Nurse Anesthetist
RN352146LPAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Weirton Medical Center Inc Current Accepting new patients
Weirton Medical Center Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 10, 2012 Accepting new patients
Weirton Medical Center Inc CurrentSince Mar 10, 2012 Accepting new patients

Locations

4000 Johnson Rd
Wintersville, OH 43952
Phone (740) 264-8011

601 Colliers Way
Weirton, WV 26062
Phone (304) 364-5156

109 Mount Wood Rd
Wheeling, WV 26003
Phone 3042332455146

Organizations & group practices 3

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1265405054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 WOODLAND PARK",
            "city": "WINTERSVILLE",
            "state": "OH",
            "postal_code": "439533855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 JOHNSON RD",
            "city": "STEUBENVILLE",
            "state": "OH",
            "postal_code": "439522300",
            "telephone_number": "740-264-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTZELL",
        "first_name": "JODIE",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN352146L",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.08149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101171560",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2173964",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Steubenville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.