Organization Active NPI

Anesthesia Associates of Wooster

  • Anesthesiology Physician
  • Wooster, OH
National Provider Identifier
1750320693
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ANESTHESIA ASSOCIATES OF WOOSTER
Practice address
1761 Beall Ave
Wooster, OH 44691-2342
Phone
(330) 263-8100
NPI assigned
Jun 6, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Eric Dehorta, MD
Title
President
Phone
(330) 263-8100

National Provider Directory

National Provider Directory

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

NPPES NPI Registry

Primary practice location

1761 Beall Ave
Wooster, OH 44691-2342

Mailing address

255 W Michigan Ave
Jackson, MI 49201-2218
Phone (517) 787-6440

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
0191868MedicaidOH

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 19, 2007.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1750320693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 BEALL AVE",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912342",
            "telephone_number": "330-263-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIA ASSOCIATES OF WOOSTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "DEHORTA",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-263-8100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0191868",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.