Brandy L Cooley-Debolt, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Dover, OH
NPI 1801940671 · NPPES record last updated Apr 21, 2010
Key facts
- NPI
- 1801940671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- RN292699 (OH)
- Practice address
- 659 Boulevard St
Dover, OH 44622-2026 - Phone
- (330) 602-0767
- Fax
- (330) 365-3831
- NPI assigned
- Jan 22, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southwest Ohio Anesthesia Consultants LLC
Practice addresses (Care Compare)
7500 State Rd
Cincinnati, OH 45255-2439
Phone (513) 624-4500
Hospital & facility affiliations
- Southeastern Ohio Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070328000425 | OH | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 8527162742 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN292699 | OH | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Ohio Anesthesia Consultants LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Southwest Ohio Anesthesia Consultants LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Ohio Anesthesia Group, Inc | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Northstar Anesthesia of Ohio LLC | Current |
Accepting new patients | |
| Barrett Pain Associates, Inc | Past |
Accepting new patients |
Locations
1341 Clark St
Cambridge, OH 43725
Phone (614) 439-8900
1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000
7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034
659 Boulevard St
Dover, OH 44622
Phone (330) 343-3311
2615 E High St
Springfield, OH 45505
Phone (888) 861-3994
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN292699 | OH | Yes |
Addresses
Primary practice location
659 Boulevard St
Dover, OH 44622-2026
Mailing address
659 Boulevard St
Dover, OH 44622-2026
Phone (330) 602-0767
Other providers in Dover, OH
- Clients to Friends to Family LLC
- Clients to Friends to Family LLC
- Austin Michael Cole
- Community Pathologists Inc
- Comprehensive Care Anesthesia Services Inc
- Kelly Lee Corbin
- Margaret Corp
- Christopher Coulson
- Country Club Center Homes, Inc
- Country Club Center Homes, Inc
All providers in Dover, OH · Certified Registered Nurse Anesthetist in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.