Individual provider Active NPI

Clayton Roush, CRNA

  • Certified Registered Nurse Anesthetist
  • Grove City, OH
National Provider Identifier
1497132005
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9323110 Issued in FL
Practice address
2977 Orders Rd
Grove City, OH 43123-8283
Phone
(304) 593-8209
NPI assigned
May 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 9323110 FL Primary

Addresses

Primary practice location

2977 Orders Rd
Grove City, OH 43123-8283

Mailing address

2977 Orders Rd
Grove City, OH 43123-8283
Phone (304) 593-8209

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160914002652 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153630256 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9323110FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of Ohio LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2016 Accepting new patients
Sandusky Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 11, 2018 Accepting new patients
Northstar Anesthesia of Ohio LLC CurrentSince Jul 5, 2016 Accepting new patients
Ams Ohio PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 7, 2018 Accepting new patients

Locations

600 N Pickaway St
Circleville, OH 43113
Phone (614) 352-6479

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

1460 Orange St
Coshocton, OH 43812
Phone (740) 545-7919

2615 E High St
Springfield, OH 45505
Phone (888) 861-3994

465 N Cleveland Ave
Ste 150
Westerville, OH 43082
Phone (614) 562-1546

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1497132005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2977 ORDERS RD",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431238283",
            "telephone_number": "304-593-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2977 ORDERS RD",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431238283",
            "telephone_number": "304-593-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSH",
        "first_name": "CLAYTON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-04",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9323110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove City, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.