Active NPI
Donald Michael Roach, CRNA
- Certified Registered Nurse Anesthetist
- Gallipolis, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- COA.9133-NA
- Practice address
- 100 Jackson Pike
Gallipolis, OH 45631-1560 - Phone
- (740) 446-5238
- Fax
- (740) 441-8058
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- 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 | COA.9133-NA | OH | Primary |
Addresses
Primary practice location
100 Jackson Pike
Gallipolis, OH 45631-1560
Mailing address
90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-5238
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001917039 | Other | MOUNTAIN STATE BCBS | |
| 2701446 | Medicaid | OH | |
| 3810007256 | Medicaid | WV | |
| 000000497528 | Other | ANTHEM BCBS | |
| P00356781 | Other | OH | RR MEDICARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | donald.roach.1@17389.direct.athenahealth.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5300 N Meadows Dr
Grove City, OH 43123-2546
Phone (614) 234-5000
Hospital & facility affiliations
- Holzer Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.27 of 100
- Quality
- 68.56
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 68.7
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA.9133-NA | OH | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Anesthesia of Ohio LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Holzer Clinic, LLC | Current | Accepting new patients | |
| I Path LLC | Current | Accepting new patients |
Locations
2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804
793 W State St
Columbus, OH 43222
Phone (614) 234-1862
100 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5050
90 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5131
5300 N Meadows Dr
Grove City, OH 43123
Phone (614) 234-4242
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.
-
- Anesthesiology Physician
- Grove City, OH
- NPI 1699196022
Nurse Anesthetist, Certified Registered
-
- Multi-Specialty Clinic/Center
- Gallipolis, OH
- NPI 1508817248
-
- Anatomic Pathology & Clinical Pathology Physician
- Gallipolis, OH
- NPI 1942525563
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rural Acute Care Hospital
- Gallipolis, OH
- NPI 1942256888
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606262400000",
"number": "1376626507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 JACKSON PIKE",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311560",
"telephone_number": "740-446-5238",
"fax_number": "740-441-8058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 JACKSON PIKE",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311560",
"telephone_number": "740-446-5238",
"fax_number": "740-441-8058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROACH",
"first_name": "DONALD",
"middle_name": "MICHAEL",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2020-11-25",
"certification_date": "2020-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OH",
"license": "COA.9133-NA",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOUNTAIN STATE BCBS",
"identifier": "001917039",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2701446",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810007256",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000497528",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00356781",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "donald.roach.1@17389.direct.athenahealth.com",
"affiliation": "N",
"address_1": "100 Jackson Pike",
"city": "Gallipolis",
"state": "OH",
"country_code": "US",
"postal_code": "456311560",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Gallipolis, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.