Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1417916305

Unknown Individual is a healthcare provider. based in Alliance, Ohio. specializing in Certified Registered Nurse Anesthetist. They hold a License No. RN284655L (PA). The NPI Number for Unknown Individual is 1417916305

Main info

Organization
Inactive
43 Years Of Experience
Name
Unknown Individual
NPI
1417916305
Phone
(330) 596-6000
Address
200 E. State Street
Deactivation Date
17 October 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4192388659
Graduation Year
1983 (43 years ago)
PAC ID
8224023486
Group Practice PAC ID
8729011333
Professional Enrollment ID
I20080306000592
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 200 E. State Street

    Alliance, OH 446014936

    Phone: (330) 596-6000

    Fax: (330) 596-7214

    Type: Location

  • 1 AMALIA DR

    BUCKHANNON, WV 262012239

    Phone: (304) 473-2000

    Type: Location

  • Aultman Alliance Community Hospital, 200, East State Street, Mount Union, Alliance, Stark County, Ohio, 44601, United States

    ALLIANCE, OH 446014936

    Phone: (330) 596-6000

    Fax: (330) 596-7214

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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 44601)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8729011333View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YIL
Certified Registered Nurse Anesthetist (Crna)OH
-MO
Certified Registered Nurse Anesthetist (Crna)AZ
Certified Registered Nurse Anesthetist (Crna)OH
A N E S T H E S I O L O G YOH
A N E S T H E S I O L O G YOR
-IL
-KS
-IN

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1417916305 in the public NPI dataset.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Certified Registered Nurse Anesthetist in this dataset. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Alliance, Ohio may find Unknown Individual in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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