Active NPI
Anesthesia Associates of Wooster
- Anesthesiology Physician
- Wooster, OH
National Provider Identifier
1750320693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- 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 DirectorySpecialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary | ||
| Certified Registered Nurse Anesthetist | 367500000X |
Addresses
NPPES NPI RegistryPrimary 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| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0191868 | Medicaid | OH |
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.