MS. AMANDA SUE JOHN (CRNA) – Certified Registered Nurse Anesthetist, NPI 1164409124
Certified Registered Nurse Anesthetist
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Profile Insights
NPPES metrics only — not quality of care.
3,016 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in OH
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Provider Addresses for MS. AMANDA SUE JOHN (CRNA)
Licking Memorial Hospital, 1320, West Main Street, Newark, Licking County, Ohio, 43055, United States
NEWARK, OH 430551822
Phone: (220) 564-4226
Fax: (220) 564-4217
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $19.
Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.
Last reported payment date: 2024-08-21 • Largest payer in this snapshot: Pacira Pharmaceuticals Incorporated ($19).
Total Amount
$19
General + Research + Ownership
Payments
1
Total payment records
General Amount
$19
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Pacira Pharmaceuticals Incorporated | $19 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-10-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20111012000468 | I | Certified Registered Nurse Anesthetist (Crna) | OH | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 43055)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| CERTIFIED REGISTERED NURSE ANESTHET | OH | 00142 | Anesthesia for lens surgery | 58 | 56 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OH | |
| Certified Registered Nurse Anesthetist (Crna) | OH | |
| - | OH | |
| Nurse Practitioner | OH | |
| O T O L A R Y N G O L O G Y | OH | |
| U R O L O G Y | OH | |
| - | OH | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OH | |
| Emergency Medicine | OH | |
| Nurse Practitioner | OH |
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