Individual provider Active NPI

Daniel William Kidney

  • Certified Registered Nurse Anesthetist
  • Dayton, OH
National Provider Identifier
1457878902
Registry record updated Sep 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
019545 Issued in OH
Practice address
405 W Grand Ave
Dayton, OH 45405-7538
Phone
(937) 723-3200
NPI assigned
Aug 25, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OH
Certified Registered Nurse Anesthetist 367500000X 019545 OH Primary

Addresses

Primary practice location

405 W Grand Ave
Dayton, OH 45405-7538

Mailing address

4256 Schrubb Dr
Dayton, OH 45429-1352
Phone (937) 626-0080

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170926002058 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981978285 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dayton Anesthesia and Pain Services LLCGroup PAC ID 8022245372, 217 clinicians

Practice addresses (Care Compare)

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone (937) 702-4000

405 W Grand Ave
Dayton, OH 45405-7538
Phone (937) 226-3200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019545OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Anesthesia & Pain Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 18, 2017 Accepting new patients
Anesthesia Associates of Cincinnati, Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2021 Accepting new patients

Locations

3535 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 702-4000

2139 Auburn Ave
Cincinnati, OH 45219
Phone (513) 585-0406

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

6939 Cox Rd
Liberty Township, OH 45069
Phone (513) 206-1460

1997 W Centerville Rd
Washington Township, OH 45459
Phone (937) 401-6000

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504915200000",
    "number": "1457878902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4256 SCHRUBB DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454291352",
            "telephone_number": "937-626-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W GRAND AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454057538",
            "telephone_number": "937-723-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDNEY",
        "first_name": "DANIEL",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-25",
        "last_updated": "2017-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "019545",
            "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 Sep 9, 2017; 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.