Jaclyn M Borchers, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Morrow, OH
NPI 1376815399 · NPPES record last updated Jun 28, 2013
Key facts
- NPI
- 1376815399
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- COA.13029-NA (OH)
- Practice address
- 1241 Shawhan Rd
Morrow, OH 45152-9695 - Phone
- (513) 865-5204
- NPI assigned
- Feb 7, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dayton Anesthesia and Pain Services LLC
Practice addresses (Care Compare)
630 Eaton Ave
Hamilton, OH 45013-2767
Phone (513) 867-2000
Hospital & facility affiliations
- Fort Hamilton Hughes Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120419000567 | OH | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 7911168851 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA.13029-NA | OH | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dayton Anesthesia & Pain Services, LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
Locations
405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200
630 Eaton Ave
Hamilton, OH 45013
Phone (513) 867-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | COA.13029-NA | OH | Yes |
Addresses
Primary practice location
1241 Shawhan Rd
Morrow, OH 45152-9695
Mailing address
PO Box 632572
Cincinnati, OH 45263-2572
Phone (513) 865-5204
Other providers in Morrow, OH
- Kevin Baldasare
- Lisa Beerse
- Bestcare Providers LLC
- J Theodore Biggs
- Frank Frimpong Boafo
- Madison Faith Bowcock
- Chloe Alexandra Bradshaw
- Leslie Manser Bright
- Joel Bromley
- Elizabeth Burgess
All providers in Morrow, OH · Certified Registered Nurse Anesthetist in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.