Timothy E Irvine, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN163057 Issued in OH

Practice address

2801 Bay Park Dr
Department of Surgery
Oregon, OH 43616-4920

Phone

(419) 690-7653

Fax

(419) 697-7726

NPI assigned

Aug 24, 2005

Last updated

May 1, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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.

• Emergency Physicians of Northwest Ohio, LLC

  • Emergency Medicine Physician
  • Fostoria, OH
  • NPI 1417911892
  NPD (past)
• Mercy Anesthesiologists Inc

  • Anesthesiology Physician
  • Springfield, OH
  • NPI 1427165570
  NPD (past)
• Surgery Center at Regency Park, LLC

  • Ambulatory Surgical Clinic/Center
  • Toledo, OH
  • NPI 1871574145
  NPD (past)
• University of Toledo Physicians LLC

  • Internal Medicine Physician
  • Toledo, OH
  • NPI 1942296033
  NPD (past)

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335830400000",
    "number": "1730172826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 BAY PARK DR",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436164920",
            "telephone_number": "419-690-7653",
            "fax_number": "419-697-7726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 BAY PARK DR",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436164920",
            "telephone_number": "419-690-7653",
            "fax_number": "419-697-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVINE",
        "first_name": "TIMOTHY",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2012-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN163057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5182130",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0768601",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "P00459029",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMO",
            "identifier": "341881145-003",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000287582",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000479672",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "04097A",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4510675",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nabeel Muhammad Imam, M.D
• Ingrid a. Alcover, MD, Inc
• Corinne A Iova, CRNA
• Essence Irby
• Makenzie Danielle Ireland, LISW
• Stewart N Isley, DO
• Randy R Jablonski, LDO
• Whitney Teresa Jablonski, CRNA
• Jack Siebenaler II MD, Inc
• Chloe Jackson

• Certified Registered Nurse Anesthetist in Oregon, OH
• Providers in Oregon, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; 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.