Individual provider Active NPI

Keith Alan Sarbaugh, CRNA

  • Certified Registered Nurse Anesthetist
  • Zanesville, OH
National Provider Identifier
1285619122
Registry record updated Apr 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
COA.00495-NA Issued in OH
Practice address
2951 Maple Ave.
Zanesville, OH 43701
Phone
(513) 672-3309
Fax
(513) 672-3323
NPI assigned
Dec 14, 2005
Last updated
Apr 5, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2010

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 123786 OH
Certified Registered Nurse Anesthetist 367500000X COA.00495-NA OH Primary

Addresses

Primary practice location

2951 Maple Ave.
Zanesville, OH 43701

Mailing address

945 Bethesda Dr.
Suite 200B
Zanesville, OH 43701
Phone (740) 455-4937

Other identifiers 2

IdentifierTypeStateIssuer
430046112OtherRAILROAD MEDICARE
0690186MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
123786OHMDCertified Registered Nurse Anesthetist
COA.00495-NAOHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Surgery & Laser Center, LLC CurrentSince Aug 1, 2007 Accepting new patients
Insight Surgery & Laser Center, LLC Past Accepting new patients
Genesis Medical Group, LLC Past Accepting new patients
Grant Anesthesia Services LTD Past Accepting new patients

Locations

3973 Northpointe Dr
Zanesville, OH 43701
Phone (740) 452-8200

3973 Northpointe Dr
#1
Zanesville, OH 43701
Phone (740) 452-8200

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, 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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270425600000",
    "number": "1285619122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 BETHESDA DR.",
            "address_2": "SUITE 200B",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "43701",
            "telephone_number": "740-455-4937",
            "fax_number": "740-455-4931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2951 MAPLE AVE.",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "43701",
            "telephone_number": "513-672-3309",
            "fax_number": "513-672-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARBAUGH",
        "first_name": "KEITH",
        "middle_name": "ALAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2010-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "123786",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.00495-NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430046112",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0690186",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.