Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1912948704

Certified Registered Nurse Anesthetist

Unknown Individual is a healthcare provider. based in Greenville, Pennsylvania. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 346435 (OH). The NPI Number for Unknown Individual is 1912948704

Main info

Organization

Inactive

50 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1912948704

Phone

(724) 646-8242

Address

110 N MAIN ST

Deactivation Date

9 January 2025

Doctor Profile

Medical School Name

OTHER

Secondary Phone

8772044155

Graduation Year

1976 (50 years ago)

PAC ID

7012904311

Group Practice PAC ID

2365418241

Professional Enrollment ID

I20040428001155

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience32

Completeness75

Years active:0State licenses:3Digital endpointsOther names

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Provider Addresses for Unknown Individual

110, Main Street, Greenville, Plumas County, California, 95947, United States
GREENVILLE, PA 161251726
Phone: (724) 646-8242
Type: Location
774, West Michigan Avenue, Jackson, Jackson County, Michigan, 49201, United States
JACKSON, MI 492011909
Phone: (517) 787-6440
Fax: (517) 787-4146
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 16125)

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Provider's Procedures

Unknown Individual performs procedures in Certified Registered Nurse Anesthetist. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
CERTIFIED REGISTERED NURSE ANESTHET	PA	01402	Anesthesia for open or endoscopic total knee joint replacement	33	32

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: 2365418241View full group profile

Name	Specialty	State
JAYSON MILLER	Certified Registered Nurse Anesthetist (Crna)	PA
ADAM S BRODGINSKI (CRNA)	Certified Registered Nurse Anesthetist (Crna)	PA
RENEE FRANCISCO	-	PA
MR. LAWRENCE W. SHOTWELL (CRNA)	Certified Registered Nurse Anesthetist (Crna)	PA
JAMES MICHAEL ERTEL (MD)	A N E S T H E S I O L O G Y	PA
SANG YOUL CHOI (MD)	A N E S T H E S I O L O G Y	FL
TIA M CALLAHAN	Certified Registered Nurse Anesthetist (Crna)	PA
MISS JESSICA PAWLOWSKI (RN)	Certified Registered Nurse Anesthetist (Crna)	PA
SANDRA WALTON (CRNA)	Certified Registered Nurse Anesthetist (Crna)	PA
MONA ARABI (MD)	-	FL

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?

CMS-hosted NPPES data lists Unknown Individual with NPI 1912948704.

Why is Unknown Individual marked inactive in the NPI directory?

The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.

What healthcare role does Unknown Individual hold?

Scheduling teams often label Unknown Individual under Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.

What address line appears for Unknown Individual?

Unknown Individual's geographic hint is Greenville, Pennsylvania in our summary view.

What does 'Individual Provider' mean on this profile?

Entity type tells you whether the number belongs to a person or an organization.