Individual provider Active NPI

Ruth Susanna Hollomon

  • Certified Registered Nurse Anesthetist
  • Dayton, OH
National Provider Identifier
1376130765
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
445994 Issued in OH
Practice address
3535 Southern Blvd
Dayton, OH 45429-1221
Phone
(937) 298-4331
NPI assigned
Dec 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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 0020258 OH
Certified Registered Nurse Anesthetist 367500000X 445994 OH Primary

Addresses

Primary practice location

3535 Southern Blvd
Dayton, OH 45429-1221

Mailing address

3533 Southern Blvd Ste 4400
Dayton, OH 45429-1273
Phone (937) 293-8228

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210302001710 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638585425 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0020258OHMDCertified Registered Nurse Anesthetist
445994OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ogi Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 14, 2024 Accepting new patients
Anesthesia Group Practice, Inc Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2022 Accepting new patients
Southwest Ohio Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 15, 2021 Accepting new patients
Sandusky Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 30, 2022 Accepting new patients
Southwest Ohio Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 15, 2021 Accepting new patients
Regional Anesthesia Group Inc Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3000 Hospital Dr
Batavia, OH 45103
Phone (513) 557-3209

L6147
Cincinnati, OH 45270

2925 Vernon Pl
Ste 101
Cincinnati, OH 45219
Phone (513) 872-4541

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

600 N Pickaway St
Circleville, OH 43113
Phone (614) 352-6479

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1376130765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 SOUTHERN BLVD STE 4400",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454291273",
            "telephone_number": "937-293-8228",
            "fax_number": "937-293-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-298-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOMON",
        "first_name": "RUTH",
        "middle_name": "SUSANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-31",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "0020258",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "445994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.