Individual provider Active NPI

Carol A Koziol, CRNA

  • Certified Registered Nurse Anesthetist
  • Omaha, NE
National Provider Identifier
1811927619
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
77346 Issued in CO
Practice address
7500 Mercy Rd Ste 1355
Omaha, NE 68124-2319
Phone
(402) 717-4866
NPI assigned
Jul 4, 2006
Last updated
Apr 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 77346 CO Primary
Certified Registered Nurse Anesthetist 367500000X 101562 NE
Certified Registered Nurse Anesthetist 367500000X D158410 IA

Addresses

Primary practice location

7500 Mercy Rd Ste 1355
Omaha, NE 68124-2319

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311

Other practice location 1

11600 W 2nd Pl
Lakewood, CO 80228-1527
Phone (719) 537-0712

Other practice location 2

800 Mercy Dr
Council Bluffs, IA 51503-3128
Phone (402) 717-4866

Other identifiers 1

IdentifierTypeStateIssuer
07773468MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77346COMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1811927619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 MERCY RD STE 1355",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242319",
            "telephone_number": "402-717-4866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11600 W 2nd Pl",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802281527",
            "country_code": "US",
            "telephone_number": "719-537-0712",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Mercy Dr",
            "address_purpose": "LOCATION",
            "city": "Council Bluffs",
            "state": "IA",
            "postal_code": "515033128",
            "country_code": "US",
            "telephone_number": "402-717-4866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZIOL",
        "first_name": "CAROL",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "77346",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "101562",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D158410",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07773468",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; 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.