Active NPI
Andrea M McDermott, CRNA
- Certified Registered Nurse Anesthetist
- Cincinnati, OH
National Provider Identifier
1356327043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 128871
- Practice address
- 7500 State Rd
Cincinnati, OH 45255-2439 - Phone
- (859) 341-7246
- Fax
- (859) 341-7867
- NPI assigned
- Dec 15, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 128871 | OH | Primary |
Addresses
Primary practice location
7500 State Rd
Cincinnati, OH 45255-2439
Mailing address
20 Medical Village Dr
Suite 258
Edgewood, KY 41017-5401
Phone (859) 341-7246
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200380670 | Medicaid | IN | |
| 728033 | Other | BUCKEYE | |
| 2092257 | Medicaid | OH | |
| 74006487 | Medicaid | KY | |
| 000000277556 | Other | ANTHEM BCBS | |
| 617595 | Other | KY | WELLCARE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 128871 | OH | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320710400000",
"number": "1356327043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 MEDICAL VILLAGE DR",
"address_2": "SUITE 258",
"city": "EDGEWOOD",
"state": "KY",
"postal_code": "410175401",
"telephone_number": "859-341-7246",
"fax_number": "859-341-7867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7500 STATE RD",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452552439",
"telephone_number": "859-341-7246",
"fax_number": "859-341-7867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDERMOTT",
"first_name": "ANDREA",
"middle_name": "M",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-15",
"last_updated": "2011-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OH",
"license": "128871",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200380670",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUCKEYE",
"identifier": "728033",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2092257",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "74006487",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000277556",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "617595",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.