Individual provider Active NPI

Michael T Amiet, CRNA

  • Certified Registered Nurse Anesthetist
  • Granville, OH
National Provider Identifier
1467436832
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA07971 Issued in OH
Practice address
102 Bedwen Bach LN
Suite B
Granville, OH 43023-1519
Phone
(740) 920-4286
NPI assigned
Nov 30, 2005
Last updated
Jan 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA07971 OH Primary
Registered Nurse 163W00000X RN278276 OH

Addresses

Primary practice location

102 Bedwen Bach LN
Suite B
Granville, OH 43023-1519

Mailing address

102 Bedwen Bach LN
Suite B
Granville, OH 43023-1519
Phone (740) 920-4286

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050511000557 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860432655 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN278276OHMDRegistered Nurse
NA07971OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mask Anesthesia Consultants Inc CurrentSince Jun 1, 2016 Accepting new patients
Premier Anesthesia of Ohio LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 6, 2014 Accepting new patients
Grant Anesthesia Services LTD Past Accepting new patients

Locations

275 Taylor Station Rd
Columbus, OH 43213
Phone (614) 566-9983

6001 E Broad St
Columbus, OH 43213
Phone (614) 224-6420

793 W State St
Columbus, OH 43222
Phone (614) 234-1862

5300 N Meadows Dr
Grove City, OH 43123
Phone (614) 234-4242

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1467436832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 BEDWEN BACH LN",
            "address_2": "SUITE B",
            "city": "GRANVILLE",
            "state": "OH",
            "postal_code": "430231519",
            "telephone_number": "740-920-4286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 BEDWEN BACH LN",
            "address_2": "SUITE B",
            "city": "GRANVILLE",
            "state": "OH",
            "postal_code": "430231519",
            "telephone_number": "740-920-4286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIET",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "NA07971",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN278276",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; 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.