Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1770536930

Unknown Individual is a healthcare provider. based in Canfield, Ohio. specializing in Certified Registered Nurse Anesthetist. They hold a License No. RN171539 (OH). The NPI Number for Unknown Individual is 1770536930

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1770536930
Phone
(330) 286-5330
Address
4135 BOARDMAN CANFIELD RD
Deactivation Date
13 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3303727470
Graduation Year
1979 (47 years ago)
PAC ID
2062414311
Group Practice PAC ID
5092979625
Professional Enrollment ID
I20070215000426
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 4135, Boardman Canfield Road, Saint Andrews, Starrs Corners, Mahoning County, Ohio, 44406, United States

    SUITE 101

    CANFIELD, OH 444069803

    Phone: (330) 286-5330

    Fax: (330) 286-5396

    Type: Mailing

  • East Liverpool City Hospital, 425, West 5th Street, Diamond Historic District, Jethro, East Liverpool, Columbiana County, Ohio, 43920, United States

    EAST LIVERPOOL, OH 439202405

    Phone: (330) 385-7200

    Fax: (330) 286-5396

    Type: Location

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 44406)

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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: 5092979625View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)OH
Certified Registered Nurse Anesthetist (Crna)OH
Certified Registered Nurse Anesthetist (Crna)FL

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1770536930.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Canfield, Ohio in the same public data insurers reference.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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