Individual provider Active NPI

Kelly Anschutz

  • Certified Registered Nurse Anesthetist
  • Bucyrus, OH
National Provider Identifier
1689056327
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
COA.17357-NA Issued in OH
Practice address
629 N Sandusky Ave
Bucyrus, OH 44820-1821
Phone
(419) 563-9391
Fax
(419) 563-9356
NPI assigned
Jun 18, 2015
Last updated
Jun 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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 COA.17357-NA OH Primary

Addresses

Primary practice location

629 N Sandusky Ave
Bucyrus, OH 44820-1821

Mailing address

700 N Columbus St
Crestline, OH 44827-1455
Phone (419) 462-3328

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151112000877 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769792290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knox Community HospitalGroup PAC ID 1153301833, 117 clinicians

Practice addresses (Care Compare)

1330 Coshocton Ave
Mount Vernon, OH 43050-1440

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.17357-NAOHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Knox Community Hospital Current Accepting new patients
Galion Community Hospital CurrentSince Oct 3, 2015 Accepting new patients
Knox Community Hospital Current Accepting new patients
Galion Community Hospital CurrentSince Oct 3, 2015 Accepting new patients
Knox Community Hospital Current Accepting new patients

Locations

629 N Sandusky Ave
Bucyrus, OH 44820
Phone (419) 562-4677

700 N Columbus St
Crestline, OH 44827
Phone (419) 462-3485

269 Portland Way S
Galion, OH 44833
Phone (419) 468-4841

1330 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9019

2981 W 4th St
Ontario, OH 44906
Phone (419) 468-0505

715 Richland Mall
Ontario, OH 44906
Phone (419) 462-4547

Organizations & group practices 5

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": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1689056327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N COLUMBUS ST",
            "city": "CRESTLINE",
            "state": "OH",
            "postal_code": "448271455",
            "telephone_number": "419-462-3328",
            "fax_number": "419-462-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 N SANDUSKY AVE",
            "city": "BUCYRUS",
            "state": "OH",
            "postal_code": "448201821",
            "telephone_number": "419-563-9391",
            "fax_number": "419-563-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSCHUTZ",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-18",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.17357-NA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bucyrus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; 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.