Individual provider Active NPI

Jeffery Steven Blubaugh, CRNA

  • Certified Registered Nurse Anesthetist
  • Alpharetta, GA
National Provider Identifier
1891108072
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
343808 Issued in OH
Practice address
2655 Northwinds Pkwy
Alpharetta, GA 30009-2280
Phone
(770) 643-5619
Fax
(678) 352-4322
NPI assigned
Jun 5, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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 343808 OH Primary

Addresses

Primary practice location

2655 Northwinds Pkwy
Alpharetta, GA 30009-2280

Mailing address

793 W State St
Mount Carmel Health System
Columbus, OH 43222-1551
Phone (770) 643-5619

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140806001964 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406073998 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knox Community HospitalGroup PAC ID 1153301833, 117 clinicians

Practice addresses (Care Compare)

1330 Coshocton Ave
Mount Vernon, OH 43050-1440
Phone (740) 393-9019

Hospital & facility affiliations

  • Knox Community Hospital Hospital, Mount Vernon, OH, CCN 360040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
343808OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Knox Community Hospital Current Accepting new patients
Knox Community Hospital CurrentSince Apr 11, 2020 Accepting new patients
Knox Community Hospital Current Accepting new patients
Knox Community Hospital CurrentSince Apr 11, 2020 Accepting new patients
New Albany Orthopedic Anesthesia LLC CurrentSince Jun 1, 2015 Accepting new patients
Premier Anesthesia of Ohio LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 24, 2014 Accepting new patients
Knox Community Hospital Current Accepting new patients

Locations

2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804

793 W State St
Columbus, OH 43222
Phone (614) 234-1862

3600 Stelzer Rd
Ste 100
Columbus, OH 43219
Phone (614) 255-2900

1330 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9019

Organizations & group practices 7

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": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1891108072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 W STATE ST",
            "address_2": "MOUNT CARMEL HEALTH SYSTEM",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221551",
            "telephone_number": "770-643-5619",
            "fax_number": "678-352-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 NORTHWINDS PKWY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300092280",
            "telephone_number": "770-643-5619",
            "fax_number": "678-352-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUBAUGH",
        "first_name": "JEFFERY",
        "middle_name": "STEVEN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "343808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.