Individual provider Active NPI

Edward E. Hettinger Jr., C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Montgomery, AL
National Provider Identifier
1497885305
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-101150 Issued in AL
Practice address
2105 E South Blvd
Montgomery, AL 36116-2409
Phone
(334) 286-3579
NPI assigned
Mar 7, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1-101150 AL Primary

Addresses

Primary practice location

2105 E South Blvd
Montgomery, AL 36116-2409

Mailing address

PO Box 235022
Montgomery, AL 36123-5022
Phone (334) 396-6930

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091005000287 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072502376 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PHS Anesthesia Billing, LLCGroup PAC ID 2264958412, 241 clinicians

Practice addresses (Care Compare)

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-8000

200 Medical Ctr Dr
Middletown, OH 45005-5200
Phone (513) 424-2111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-101150ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Arlington Anesthesia Partners LLC CurrentSince Feb 21, 2025 Accepting new patients
PHS Anesthesia Billing, LLC CurrentSince Dec 6, 2025 Accepting new patients
Gi Anesthesia, LLC CurrentSince Oct 9, 2015 Accepting new patients
Anesthesiology Services Network LTD CurrentSince Apr 1, 2017 Accepting new patients
Ogi Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 15, 2015 Accepting new patients
Premier Anesthesia of Montgomery PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2925 Vernon Pl
Ste 101
Cincinnati, OH 45219
Phone (513) 872-4541

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

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

4340 Clyo Rd
#200
Dayton, OH 45459
Phone (937) 396-2602

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

5950 Innovation Dr
Middletown, OH 45005
Phone (513) 261-6200

4746 Montgomery Rd
Ste 100
Norwood, OH 45212
Phone (513) 569-1310

Organizations & group practices 6

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.

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497885305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235022",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235022",
            "telephone_number": "334-396-6930",
            "fax_number": "334-396-6929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 E SOUTH BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162409",
            "telephone_number": "334-286-3579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETTINGER",
        "first_name": "EDWARD",
        "middle_name": "E.",
        "name_suffix": "Jr.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-101150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.