Individual provider Active NPI

Matthew Christian Killingsworth, CRNA

  • Certified Registered Nurse Anesthetist
  • Athens, OH
National Provider Identifier
1972051282
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.0020926 Issued in OH
Practice address
55 Hospital Dr
Athens, OH 45701-2302
Phone
(614) 566-9871
NPI assigned
Sep 15, 2016
Last updated
Jan 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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 94944 WV
Certified Registered Nurse Anesthetist 367500000X APRN.CRNA.0020926 OH Primary

Addresses

Primary practice location

55 Hospital Dr
Athens, OH 45701-2302

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170209001072 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668755075 Reassigns benefits to 3 organizations
I20240201003296 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668755075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians
Camden-Clark Physician CorporationGroup PAC ID 5294885661, 345 clinicians

Practice addresses (Care Compare)

55 Hospital Dr
Athens, OH 45701-2302
Phone (740) 566-4530

800 Garfield Ave
Parkersburg, WV 26101-5376
Phone (304) 424-2111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
94944WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2024 Accepting new patients
Pars Neurosurgical Associates, Inc CurrentSince Feb 5, 2018 Accepting new patients
United Anesthesia, Inc. Nurse Anesthetist, Certified Registered CurrentSince Dec 11, 2016 Accepting new patients
Ohiohealth Corporation CurrentSince Jan 1, 2024 Accepting new patients
Camden-Clark Physician Corporation CurrentSince Feb 20, 2025 Accepting new patients
Camden Clark Memorial Hospital Corporation Past Accepting new patients

Locations

55 Hospital Dr
Athens, OH 45701
Phone (740) 592-9349

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

1212 Garfield Ave
Ste 300
Parkersburg, WV 26101
Phone (304) 424-4130

3211 Dudley Ave
Parkersburg, WV 26104
Phone (304) 422-3904

601 Avery St
Ste 501
Parkersburg, WV 26101
Phone (304) 422-3904

800 Garfield Ave
Parkersburg, WV 26101
Phone (304) 420-7161

800 Garfield Ave
Rm G101
Parkersburg, WV 26101
Phone (304) 422-0405

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.

Hospital & facility affiliations 3

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": "1473897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1972051282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727",
            "fax_number": "614-544-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HOSPITAL DR",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457012302",
            "telephone_number": "614-566-9871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLINGSWORTH",
        "first_name": "MATTHEW",
        "middle_name": "CHRISTIAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-15",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "94944",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.0020926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.