Individual provider Active NPI

Nolan Michael Nadzam, CRNA

  • Certified Registered Nurse Anesthetist
  • Salem, OH
National Provider Identifier
1811212681
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
COA.11389-NA Issued in OH
Practice address
1995 E State St
Salem, OH 44460-2423
Phone
(330) 759-9350
Fax
(330) 759-9387
NPI assigned
Apr 5, 2010
Last updated
Mar 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X COA.11389-NA OH Primary
Registered Nurse 163W00000X RN-288403 OH

Addresses

Primary practice location

1995 E State St
Salem, OH 44460-2423

Mailing address

3622 Belmont Ave
1
Youngstown, OH 44505-1450
Phone (330) 759-9350

Other identifiers 2

IdentifierTypeStateIssuer
3037921MedicaidOH
12102006OtherOHCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100428000631 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688701311 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orrville Hospital FoundationGroup PAC ID 7911890546, 78 clinicians

Practice addresses (Care Compare)

832 S Main St
Orrville, OH 44667-2208
Phone (330) 682-3010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN-288403OHMDRegistered Nurse
COA.11389-NAOHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Ohio LLC CurrentSince May 1, 2013 Accepting new patients
Orrville Hospital Foundation CurrentSince Jul 1, 2015 Accepting new patients
Orrville Hospital Foundation CurrentSince Jul 1, 2015 Accepting new patients
Associates in Anesthesiology, Inc Past Accepting new patients
Advanced Anesthesia Associates,Inc Past Accepting new patients

Locations

832 S Main St
Orrville, OH 44667
Phone (330) 456-2695

2615 E High St
Springfield, OH 45505
Phone (888) 861-3994

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300320000000",
    "number": "1811212681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3622 BELMONT AVE",
            "address_2": "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": "330-759-9350",
            "fax_number": "330-759-9387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADZAM",
        "first_name": "NOLAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-05",
        "last_updated": "2011-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.11389-NA",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN-288403",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3037921",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12102006",
            "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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.