Individual provider Active NPI

Petronilla Onwu

  • Certified Registered Nurse Anesthetist
  • Augusta, GA
National Provider Identifier
1699011429
Registry record updated Jun 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R160368 Issued in MD
Practice address
804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464
Phone
(800) 394-4445
NPI assigned
Dec 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2024

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 R160368 MD Primary

Addresses

Primary practice location

804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464

Mailing address

804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130408000304 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0244475622 Reassigns benefits to 3 organizations
I20170724001285 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 0244475622 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Company LLCGroup PAC ID 4587559026, 373 clinicians

Practice addresses (Care Compare)

2001 Medical Pkwy
Annapolis, MD 21401-3773
Phone (443) 481-1000

8118 Good Luck Rd
Lanham, MD 20706-3574
Phone (301) 552-8118

8905 Fairview Rd
Silver Spring, MD 20910-4150
Phone (888) 554-0631

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R160368MDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 3, 2014 Accepting new patients
Anesthesia Company, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2021 Accepting new patients
Caring Community Support Incorporated Current Accepting new patients
North American Partners in Anesthesia Maryland LLC CurrentSince Jun 1, 2017 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 3, 2014 Accepting new patients

Locations

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

6430 Rockledge Dr
Ste 160
Bethesda, MD 20817
Phone (301) 312-6144

3001 Hospital Dr
Hyattsville, MD 20785
Phone (301) 618-2000

800 Prince Frederick Blvd
Prnc Frederck, MD 20678
Phone (410) 535-2270

70 Sherry Ln
Ste 101
Prnc Frederck, MD 20678
Phone (410) 889-2040

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

8905 Fairview Rd
Silver Spring, MD 20910
Phone (888) 554-0631

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

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 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": "1356480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717286400000",
    "number": "1699011429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464",
            "telephone_number": "800-394-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONWU",
        "first_name": "PETRONILLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-26",
        "last_updated": "2024-06-02",
        "certification_date": "2024-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R160368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "804 Scott Nixon Memorial Dr",
            "city": "Augusta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "309072464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2024; 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.