Individual provider Active NPI

Mary E. Jedlicka, APRN.CRNA

  • Certified Registered Nurse Anesthetist
  • Columbus, OH
National Provider Identifier
1538798699
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.0020095 Issued in OH
Practice address
410 W 10TH Ave FL 1
Columbus, OH 43210-1240
Phone
(614) 293-8487
Fax
(614) 293-8153
NPI assigned
Apr 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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 APRN.CRNA.0020095 OH Primary

Addresses

Primary practice location

410 W 10TH Ave FL 1
Columbus, OH 43210-1240

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-8487

Other practice location 1

272 Hospital Rd
Chillicothe, OH 45601-9031
Phone (740) 779-7540

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adena@adena.medicity.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200721002928 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173947371 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Observation Medicine, LLCGroup PAC ID 3375692270, 423 clinicians
Premier Anesthesia of Ohio LLCGroup PAC ID 3779714258, 123 clinicians

Practice addresses (Care Compare)

410 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8487

5300 N Meadows Dr
Grove City, OH 43123-2546
Phone (614) 234-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of Ohio LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 23, 2021 Accepting new patients
Sandusky Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2022 Accepting new patients
Osu Observation Medicine, LLC CurrentSince Jan 1, 2023 Accepting new patients
Adena Medical Group LLC CurrentSince Jan 24, 2022 Accepting new patients

Locations

272 Hospital Rd
Chillicothe, OH 45601
Phone (740) 779-4275

4437 State Route 159
Ste 125
Chillicothe, OH 45601
Phone (740) 779-4570

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

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

410 W 10th Ave
Fl 1
Columbus, OH 43210

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

410 W 10th Ave
#N429
Columbus, OH 43210
Phone (614) 293-4705

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

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

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.

Hospital & facility affiliations 5

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": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1538798699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W 10TH AVE FL 1",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-293-8487",
            "fax_number": "614-293-8153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "272 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "456019031",
            "country_code": "US",
            "telephone_number": "740-779-7540",
            "fax_number": "740-779-7867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEDLICKA",
        "first_name": "MARY",
        "middle_name": "E.",
        "credential": "APRN.CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.0020095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena@adena.medicity.net",
            "affiliation": "N",
            "address_1": "272 Hospital Rd",
            "city": "Chillicothe",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456019031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.