Active NPI
Rosemary Pavlich, CRNA
- Certified Registered Nurse Anesthetist
- Alliance, OH
National Provider Identifier
1962476564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN128393
- Practice address
- 200 E State St
Alliance, OH 44601 - Phone
- (330) 596-7227
- Fax
- (330) 286-5396
- NPI assigned
- Feb 13, 2006
- Last updated
- Jun 25, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN128393 | OH | Primary |
Addresses
Primary practice location
200 E State St
Alliance, OH 44601
Mailing address
4135 Boardman Canfield Rd Ste 101
Canfield, OH 44406-9803
Phone (330) 286-5330
Other practice location 1
667 Eastland Ave SE
SE
Warren, OH 44484-4503
Phone (330) 759-9350
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 29408 | Other | PA | CRNA CERTIFICATE |
| 0758434 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN128393 | OH | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Anesthesia Group, Inc. | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Anesthesiology Consultants of Toledo, Inc | Past | Accepting new patients | |
| Charles Cole Memorial Hospital D/B/a Upmc Cole | Past | Accepting new patients | |
| Akron Pediatric Ophthalmology and Ophthalmic Plastic Surgery, Inc | Past | Accepting new patients | |
| Anesthesia Associates of Easton, P C | Past | Accepting new patients |
Organizations & group practices 6
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.
-
- Specialist
- Akron, OH
- NPI 1710062013
-
- Anesthesiology Physician
- Toledo, OH
- NPI 1366482119
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- Certified Registered Nurse Anesthetist
- Akron, OH
- NPI 1255526240
Nurse Anesthetist, Certified Registered
-
- Specialist
- Easton, PA
- NPI 1952305930
-
- Dentist
- Coudersport, PA
- NPI 1548618853
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529884800000",
"number": "1962476564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4135 BOARDMAN CANFIELD RD STE 101",
"city": "CANFIELD",
"state": "OH",
"postal_code": "444069803",
"telephone_number": "330-286-5330",
"fax_number": "330-286-5396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 E STATE ST",
"city": "ALLIANCE",
"state": "OH",
"postal_code": "44601",
"telephone_number": "330-596-7227",
"fax_number": "330-286-5396"
}
],
"practiceLocations": [
{
"address_1": "667 Eastland Ave SE",
"address_2": "SE",
"address_purpose": "LOCATION",
"city": "Warren",
"state": "OH",
"postal_code": "444844503",
"country_code": "US",
"telephone_number": "330-759-9350",
"fax_number": "330-759-9387",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAVLICH",
"first_name": "ROSEMARY",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-13",
"last_updated": "2018-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OH",
"license": "RN128393",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRNA CERTIFICATE",
"identifier": "29408",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0758434",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Alliance, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.