Active NPI
Kimberly Ronae Nadzam, CRNA
- Certified Registered Nurse Anesthetist
- Youngstown, OH
National Provider Identifier
1356663686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 083420
- Practice address
- 3622 Belmont Ave
1
Youngstown, OH 44505-1450 - Phone
- (330) 759-9350
- Fax
- (330) 759-9387
- NPI assigned
- Mar 1, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 083420 | OH | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | RN272694 | OH |
Addresses
Primary practice location
3622 Belmont Ave
1
Youngstown, OH 44505-1450
Mailing address
3622 Belmont Ave
1
Youngstown, OH 44505-1450
Phone (330) 759-9350
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12105017 | Other | OH | CAQH |
| 3031703 | Medicaid | OH |
Other names 1
- Kimberly Ronae Miller
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 88.59 of 100
- Quality
- 83.4
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 78.58
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 083420 | OH | MD | Certified Registered Nurse Anesthetist |
| RN272694 | OH | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gastroenterology Specialists Inc | Current | Accepting new patients | |
| Northstar Anesthesia of Ohio LLC | Current | Accepting new patients | |
| Gastroenterology Specialists Inc | Current | Accepting new patients | |
| Associates in Anesthesiology, Inc | Past | Accepting new patients | |
| Advanced Anesthesia Associates,Inc | Past | Accepting new patients |
Locations
2726 Fulton Dr NW
Canton, OH 44718
Phone (330) 455-5011
2615 E High St
Springfield, OH 45505
Phone (888) 861-3994
Interoperability endpoints
- https://a8580225-25d6-4812-a463-58e49a80f214.gastro.prod.fhir.ema-api.com/fhir/r4/
Organizations & group practices 5
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.
-
- Gastroenterology Physician
- Canton, OH
- NPI 1831171974
-
- Anesthesiology Physician
- Springfield, OH
- NPI 1417276429
-
- Ambulatory Surgical Clinic/Center
- Canton, OH
- NPI 1447231287
-
- Anesthesiology Physician
- Youngstown, OH
- NPI 1538117460
-
- Specialist
- Youngstown, OH
- NPI 1346234044
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350864000000",
"number": "1356663686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3622 BELMONT AVE",
"address_2": "1",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445051450",
"telephone_number": "330-759-9350",
"fax_number": "330-759-9387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3622 BELMONT AVE",
"address_2": "1",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445051450",
"telephone_number": "330-759-9350",
"fax_number": "330-759-9387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NADZAM",
"first_name": "KIMBERLY",
"middle_name": "RONAE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-01",
"last_updated": "2012-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OH",
"license": "083420",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OH",
"license": "RN272694",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12105017",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3031703",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KIMBERLY",
"last_name": "MILLER",
"middle_name": "RONAE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.