Individual provider Active NPI

Aaron McClellan, CRNA

  • Certified Registered Nurse Anesthetist
  • Lebanon, NH
National Provider Identifier
1881016822
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
069059-23 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone
(603) 650-5922
NPI assigned
Jan 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 069059-23 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Mailing address

500 Freeman Rd
Plainfield, NH 03781-5022
Phone (208) 220-2929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190204001643 WY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204067903 Reassigns benefits to 2 organizations
I20191101002467 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204067903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital of Converse CountyGroup PAC ID 2264340843, shared by 5 NPIs, 77 clinicians
Blackfoot Anesthesia Services, LLCGroup PAC ID 8224006101, 3 clinicians

Practice addresses (Care Compare)

111 S 5TH St
Douglas, WY 82633-2434
Phone (307) 358-2122

2025 E 17TH St
Idaho Falls, ID 83404-6430
Phone (208) 524-2025

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
069059-23NHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates, LLC CurrentSince Dec 10, 2018 Accepting new patients
Memorial Hospital of Converse County Current Accepting new patients
Memorial Hospital of Converse County CurrentSince Mar 1, 2024 Accepting new patients

Locations

1441 Wilkins Cir
Casper, WY 82601
Phone (307) 265-1792

6350 E 2nd St
Casper, WY 82609
Phone (307) 232-6600

111 S 5th St
Douglas, WY 82633
Phone (307) 358-6200

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1881016822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 FREEMAN RD",
            "city": "PLAINFIELD",
            "state": "NH",
            "postal_code": "037815022",
            "telephone_number": "208-220-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "AARON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-10",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "069059-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; 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.