Individual provider Active NPI

Camille McNicholas, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Harwinton, CT
National Provider Identifier
1972670073
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
001540 Issued in CT
Practice address
444 Clearview Ave
Harwinton, CT 06791-1020
Phone
(860) 884-5402
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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 001540 CT Primary

Addresses

Primary practice location

444 Clearview Ave
Harwinton, CT 06791-1020

Mailing address

444 Clearview Ave
Harwinton, CT 06791-1020
Phone (860) 884-5402

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040223000602 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648166215 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charter Anesthesiology LLCGroup PAC ID 2163763830, 34 clinicians

Practice addresses (Care Compare)

41 Brewster Rd
Bristol, CT 06010-5161
Phone (800) 585-3000

Hospital & facility affiliations

  • Bristol Hospital Hospital, Bristol, CT, CCN 070029

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1540CTMDBehavioral Analyst
001540CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia Connecticut PC CurrentSince Nov 4, 2018 Accepting new patients
Integrated Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 22, 2014 Accepting new patients
Woodland Anesthesia Associates PC CurrentSince Jan 19, 2020 Accepting new patients
Charter Anesthesiology LLC CurrentSince Jul 31, 2019 Accepting new patients
Anesthesia Associates of Willimantic PC CurrentSince May 9, 2016 Accepting new patients
NM Anesthesia Associates, PC Past Accepting new patients

Locations

701 Cottage Grove Rd
Ste F230
Bloomfield, CT 06002
Phone (860) 243-5569

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249

300 Seaside Ave
Milford, CT 06460
Phone (203) 876-4000

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

52 Washington Ave
Ste 1
North Haven, CT 06473
Phone (203) 234-7727

37 Kennedy Dr
Ste C
Putnam, CT 06260
Phone (860) 423-7558

2600 Tamarack Ave
#200
South Windsor, CT 06074
Phone (860) 646-1157

201 Chestnut Hill Rd
Stafford Springs, CT 06076
Phone (860) 265-6521

1312 W Main St
Ste 101
Waterbury, CT 06708
Phone (203) 346-2200

1185 Main St
Willimantic, CT 06226
Phone (860) 423-7558

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 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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1972670073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 CLEARVIEW AVE",
            "city": "HARWINTON",
            "state": "CT",
            "postal_code": "067911020",
            "telephone_number": "860-884-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 CLEARVIEW AVE",
            "city": "HARWINTON",
            "state": "CT",
            "postal_code": "067911020",
            "telephone_number": "860-884-5402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNICHOLAS",
        "first_name": "CAMILLE",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "001540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harwinton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; 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.