NPIMap

Organization Active NPI

Anesthesia Services of Greater Dayton, LLC

  • Certified Registered Nurse Anesthetist
  • Beavercreek, OH
National Provider Identifier
1407132830
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
ANESTHESIA SERVICES OF GREATER DAYTON, LLC
Practice address
4235 Indian Ripple Rd
Beavercreek, OH 45440-3284
Phone
(937) 427-2020
NPI assigned
Oct 31, 2011
Last updated
Dec 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Authorized official

Name
Ms. Kimberly Riviello, CRNANPI 1528002417
Title
President
Phone
(937) 287-8178

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X Primary

Addresses

Primary practice location

4235 Indian Ripple Rd
Beavercreek, OH 45440-3284

Mailing address

4155-A Lisa Dr.
Tipp City, OH 45371-8425
Phone (937) 287-8178

Other practice location 1

4155-A Lisa Dr.
Tipp City, OH 45371-8425
Phone (937) 287-8178

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121004000714 OH Part B Supplier - Clinic/Group Practice 1658520747 Receives reassigned benefits from 78 practitioners
Practice locations: Beavercreek, OH; Cincinnati, OH; Dayton, OH; Marion, OH; Richmond HTS, OH

National Provider Directory

National Provider Directory

Locations

4155 Lisa Dr
#A
Tipp City, OH 45371
Phone (937) 287-8178

Practitioners & affiliated clinicians

Practitioners 82

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 82

NPI Registry JSON

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672185600000",
    "number": "1407132830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4155-A LISA DR.",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "453718425",
            "telephone_number": "937-287-8178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 INDIAN RIPPLE RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454403284",
            "telephone_number": "937-427-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4155-A Lisa Dr.",
            "address_purpose": "LOCATION",
            "city": "Tipp City",
            "state": "OH",
            "postal_code": "453718425",
            "country_code": "US",
            "telephone_number": "937-287-8178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANESTHESIA SERVICES OF GREATER DAYTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-31",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A",
        "authorized_official_last_name": "RIVIELLO",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-287-8178",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.