Individual provider Active NPI

Tina McCoy, CRNA

  • Certified Registered Nurse Anesthetist
  • Dayton, OH
National Provider Identifier
1992834428
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.01342 Issued in OH
Practice address
1 Wyoming St
Dayton, OH 45409-2722
Phone
(937) 208-6173
Fax
(937) 208-3843
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 047611 OH
Certified Registered Nurse Anesthetist 367500000X APRN.CRNA.01342 OH Primary

Addresses

Primary practice location

1 Wyoming St
Dayton, OH 45409-2722

Mailing address

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-6173

Other identifiers 1

IdentifierTypeStateIssuer
2145164MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050629000861 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062458136 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Cincinnati College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PHS Anesthesia Billing, LLCGroup PAC ID 2264958412, 241 clinicians

Practice addresses (Care Compare)

200 Medical Ctr Dr
Middletown, OH 45005-5200
Phone (513) 424-2111

Hospital & facility affiliations

  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047611OHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Services Network LTD Anesthesiology CurrentSince Sep 29, 1996 Accepting new patients
PHS Anesthesia Billing, LLC Anesthesiology CurrentSince Apr 14, 2025 Accepting new patients

Locations

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

6601 Centerville Business Pkwy
Dayton, OH 45459
Phone (937) 208-2111

3484 Far Hills Ave
Kettering, OH 45429
Phone (937) 208-4380

200 Medical Center Dr
Middletown, OH 45005
Phone (937) 276-8320

Organizations & group practices 2

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": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1992834428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092722",
            "telephone_number": "937-208-6173",
            "fax_number": "937-208-3843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092722",
            "telephone_number": "937-208-6173",
            "fax_number": "937-208-3843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "TINA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "047611",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.01342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2145164",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.