Active NPI
Eleanor J McKenzie, CRNA
- Certified Registered Nurse Anesthetist
- Salem, OH
National Provider Identifier
1699721563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- COA.02695-NA
- Practice address
- 1995 E State St
Salem, OH 44460-2423 - Phone
- (330) 332-1551
- Fax
- (330) 332-7663
- NPI assigned
- May 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN210273L | PA | |
| Registered Nurse | 163W00000X | RN-112502 | OH | |
| Certified Registered Nurse Anesthetist | 367500000X | COA.02695-NA | OH | Primary |
Addresses
Primary practice location
1995 E State St
Salem, OH 44460-2423
Mailing address
3622 Belmont Ave
Suite 1
Youngstown, OH 44505-1450
Phone (330) 759-9350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0767746 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN-112502 | OH | MD | Registered Nurse |
| COA.02695-NA | OH | MD | Certified Registered Nurse Anesthetist |
| RN210273L | PA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Anesthesia Associates,Inc | Past | Accepting new patients | |
| Anesthesiology Consultants of Toledo, Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Youngstown, OH
- NPI 1538117460
-
- Anesthesiology Physician
- Toledo, OH
- NPI 1366482119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300320000000",
"number": "1699721563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3622 BELMONT AVE",
"address_2": "SUITE 1",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445051450",
"telephone_number": "330-759-9350",
"fax_number": "330-759-9387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1995 E STATE ST",
"city": "SALEM",
"state": "OH",
"postal_code": "444602423",
"telephone_number": "330-332-1551",
"fax_number": "330-332-7663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENZIE",
"first_name": "ELEANOR",
"middle_name": "J",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-25",
"last_updated": "2011-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "PA",
"license": "RN210273L",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "RN-112502",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OH",
"license": "COA.02695-NA",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0767746",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Salem, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.