Individual provider Active NPI

Dustin Lee Peaytt, RN, BSN, DMPNA

  • Certified Registered Nurse Anesthetist
  • Jackson, OH
National Provider Identifier
1609303437
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRNCRNA019528 Issued in OH
Practice address
280 Pattonsville Rd
Jackson, OH 45640-9452
Phone
(855) 446-5937
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.437658 OH
Certified Registered Nurse Anesthetist 367500000X APRNCRNA019528 OH Primary

Addresses

Primary practice location

280 Pattonsville Rd
Jackson, OH 45640-9452

Mailing address

90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 441-1949

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170727003107 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587934203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
JC Edwards School of Medicine, Marshall University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Anesthesia of Ohio LLCGroup PAC ID 3779714258, 123 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.27 of 100Reported as group
Quality
68.56
Promoting interoperability
100
Improvement activities
40
Cost
68.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Certified Registered Nurse, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.437658OHMDRegistered Nurse
APRNCRNA019528OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Holzer Clinic, LLC CurrentSince Aug 16, 2021 Accepting new patients
I Path LLC Current Accepting new patients
Premier Anesthesia of Ohio LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2025 Accepting new patients

Locations

2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804

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

100 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5050

90 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5131

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

280 Pattonsville Rd
Jackson, OH 45640
Phone (740) 395-8805

Interoperability endpoints

  • Direct secure messaging: dustin.peaytt.1@17389.direct.athenahealth.com

Organizations & group practices 3

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 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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1609303437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-441-1949",
            "fax_number": "740-446-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 PATTONSVILLE RD",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456409452",
            "telephone_number": "855-446-5937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEAYTT",
        "first_name": "DUSTIN",
        "middle_name": "LEE",
        "credential": "RN, BSN, DMPNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.437658",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRNCRNA019528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.