Individual provider Active NPI

Tina Marie Gruly, CRNA

  • Certified Registered Nurse Anesthetist
  • Painesville, OH
National Provider Identifier
1598848814
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.09086 Issued in OH
Practice address
7757 Auburn Rd Ste 15
Painesville, OH 44077-9604
Phone
(440) 350-0832
Fax
(440) 354-7420
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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 RN285691 OH
Certified Registered Nurse Anesthetist 367500000X APRN.CRNA.09086 OH Primary

Addresses

Primary practice location

7757 Auburn Rd Ste 15
Painesville, OH 44077-9604

Mailing address

7757 Auburn Rd Ste 15
Painesville, OH 44077-9604
Phone (440) 350-0832

Other identifiers 1

IdentifierTypeStateIssuer
RN285691OtherOHOHIO BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN285691OHMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1598848814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7757 AUBURN RD STE 15",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440779604",
            "telephone_number": "440-350-0832",
            "fax_number": "440-354-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7757 AUBURN RD STE 15",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440779604",
            "telephone_number": "440-350-0832",
            "fax_number": "440-354-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRULY",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN285691",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.09086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO BOARD OF NURSING",
            "identifier": "RN285691",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Painesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.