JANA PETELLE (NPI# 1396194643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396194643 |
| Entity Type | Individual |
| Full Name | JANA PETELLE |
| Credential | CRNA |
| Practice Address |
716 Stevens Ave Portland ME 04103-2656 |
| Mailing Address |
789 Central Ave Dover NH 03820-2526 |
| Practice Telephone | 2072214516 |
| Mailing Telephone | 6036096819 |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2020-06-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 367500000X | Nurse Anesthetist, Certified Registered | 082357-23 | NH | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 367500000X | Nurse Anesthetist, Certified Registered | RNA183052 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NH | 3122430 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 300 Main St, Lewiston, ME 042407027 | 2077950111 | |
| 789 Central Ave, Dover, NH 038202526 | 6036096819 | 6036096821 |
| Street Address |
716 STEVENS AVE |
| City | PORTLAND |
| State | ME |
| Zip Code | 04103-2656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346245990 | Lee Edward Niemeyer | Dentist | 716 Stevens Ave, Portland, ME 04103-2656 | 2005-06-20 |
| 1710505433 | Colin Hulst | Registered Nurse | 716 Stevens Ave, Portland, ME 04103-2656 | 2020-07-09 |
| 1346864279 | Lievin Umba | Physician Assistant | 716 Stevens Ave, Portland, ME 04103-2656 | 2020-06-06 |
| 1184248312 | Wendy Letchworth | Student in an Organized Health Care Education/Training Program | 716 Stevens Ave, Portland, ME 04103-2656 | 2020-06-03 |
| 1619591930 | Geoffrey Kamau Wahome | Student in an Organized Health Care Education/Training Program | 716 Stevens Ave, Portland, ME 04103-2656 | 2020-06-02 |
| 1891319398 | Jordan Ray Kelley | Student in an Organized Health Care Education/Training Program | 716 Stevens Ave, Portland, ME 04103-2693 | 2020-06-01 |
| 1073137659 | Jaclyn Elizabeth Masters | Student in an Organized Health Care Education/Training Program | 716 Stevens Ave, Portland, ME 04103-2656 | 2020-05-30 |
| 1508480260 | Carla D'amour | Student in an Organized Health Care Education/Training Program | 716 Stevens Ave, Portland, ME 04103-2656 | 2020-05-28 |
| 1003439779 | Matthew Scott Austin | Student in an Organized Health Care Education/Training Program | 716 Stevens Ave, Portland, ME 04103-2656 | 2020-05-28 |
| 1598389256 | Novisi Abba | Student in an Organized Health Care Education/Training Program | 716 Stevens Ave, Portland, ME 04103-2693 | 2020-05-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790302677 | Hope for All Community Services LLC | Community/Behavioral Health | 68 Bishop St, Building 1, Unit 1, Portland, ME 04103 | 2020-06-26 |
| 1982251435 | Hope Home Healthcare, LLC | Home Health | 68 Bishop St Unit 3 #2, Portland, ME 04103 | 2019-08-20 |
| 1992367023 | Care for Everyone | In Home Supportive Care | 68 Bishop Street, Unit 1, Room 5, Portland, ME 04103 | 2019-06-28 |
| 1093373458 | Emanuel Nistrian | Student in an Organized Health Care Education/Training Program | Une, 716 Stevens Ave., Portland, ME 04103 | 2019-05-31 |
| 1023676483 | Robert Montague | Student in an Organized Health Care Education/Training Program | University of New England, 716 Stevens Ave, Portland, ME 04103 | 2019-05-31 |
| 1154838027 | Kimberly Therriault | Behavior Technician | 527 Ocean Ave Ste 19, Portland, ME 04103 | 2018-01-02 |
| 1285147918 | Teresa Maalouf | Community Health Worker | 23 Cambridge St., Portland, ME 04103 | 2017-11-16 |
| 1578082244 | Darcelle Kay Stillman | Occupational Therapist | 90 Dorothy St, Portland, ME 04103 | 2017-09-14 |
| 1821524943 | Engility Enterprises LLC | Case Management | 1 Coast Lane, Portland, ME 04103 | 2017-05-10 |
| 1720524283 | Hannah Rose Kazilionis | Counselor | 257 Deering Ave # 204, Portland, ME 04103 | 2017-01-09 |
| Find all providers in zip 04103 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841811338 | Abby Zarotny Sahagian | Nurse Anesthetist, Certified Registered | Mmc Anesthesia and Perioperative Medicine, 22 Bramhall St, Portland, ME 04102 | 2020-05-06 |
| 1164871331 | Andrea Farrar | Nurse Anesthetist, Certified Registered | 716 Steven's Ave, Portland, ME 04039 | 2016-06-08 |
| 1942695770 | 10th Planet LLC | Nurse Anesthetist, Certified Registered | 2125 Se Oak St, Portland, OR 97214-1606 | 2015-03-30 |
| 1407120926 | Reynaldo D Calaro Jr. | Nurse Anesthetist, Certified Registered | 6919 N Commercial Ave, Portland, OR 97217-1713 | 2012-03-01 |
| 1922376557 | Jacob Andre Mclain | Nurse Anesthetist, Certified Registered | 3736 Se Cora St, Portland, OR 97202-3238 | 2011-12-10 |
| 1639476153 | Emily Kathryn Goerke | Nurse Anesthetist, Certified Registered | 6400 Se Lake Road, Suite 130, Anesthesia Associates Northwest, Portland, OR 97222 | 2011-02-18 |
| 1770727158 | Michael Angelo Tantay | Nurse Anesthetist, Certified Registered | 125 Nw 20th Place, Unit No 511, Portland, OR 97209-1042 | 2009-04-29 |
| 1174722888 | Scott A Jolliffe | Nurse Anesthetist, Certified Registered | 9701 Sw Barnes Rd Ste 310, Portland, OR 97225-6689 | 2007-07-12 |
| 1518015551 | Anne D Sherwood | Nurse Anesthetist, Certified Registered | 1401 Se 52nd Ave, Portland, OR 97215-2638 | 2007-01-08 |
| 1043324635 | Bonnie Helen O'hara | Nurse Anesthetist, Certified Registered | Providence St. Vincent Medical Center, 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2006-08-19 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.