Nicole Jean Hennicke, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN.323311 Issued in OH

Practice address

11100 Euclid Ave
Cleveland, OH 44106

Phone

(216) 844-7334

NPI assigned

Jan 21, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Nicole Jean Gentry Former name

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Transformative Anesthesia, LLCGroup PAC ID 6204339864, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marymount Hospital Hospital, Garfield Heights, OH, CCN 360143
• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Transformative Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Fairview Park, OH
  • NPI 1144111204

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Ohio Anesthesia Group, Inc

  • Anesthesiology Physician
  • Canton, OH
  • NPI 1639348113

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Marymount Hospital Inc

  • General Acute Care Hospital
  • Garfield Heights, OH
  • NPI 1942248737
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

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

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345766400000",
    "number": "1396040432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24700 EUCLID AVE",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "44117",
            "telephone_number": "216-383-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44106",
            "telephone_number": "216-844-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNICKE",
        "first_name": "NICOLE",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-21",
        "last_updated": "2012-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN.323311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN.323311",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3142843",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "GENTRY",
            "middle_name": "JEAN",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Yick Chin Heng, MD
• Andrew Franklin Henn, D.O.
• Holly Ann Hennessey
• Elizabeth Hennessy
• Elizabeth Marie Hennessy
• Erica L Hennigs, PA
• Samantha Lauren Hennis, MSN, APRN, AGACNP-BC
• Christina Marie Henrich, MSN, RN, ACNS-BC
• Walter H Henricks III, M.D.
• Carlotta Chaya Henriquez-Smith, RPH

• Certified Registered Nurse Anesthetist in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.

Verify at the official NPI Registry.