Basic Information
| Provider Information | |||||||||
| NPI: | 1407849599 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIGOT | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 20452 | ||||||||
| Address2: | WOAA CREDENTIALING | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432200452 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144578180 | ||||||||
| FaxNumber: | 6145833300 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 N POPLAR ST | ||||||||
| Address2: | MCCULLOUGH HYDE MEM HOSP ANESTHESIOLOGY DEPT | ||||||||
| City: | OXFORD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450561204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135245440 | ||||||||
| FaxNumber: | 5135245559 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2005 | ||||||||
| LastUpdateDate: | 01/15/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 261456 | OH | N | Nursing Service Providers | Registered Nurse | 163W00000X | 1102607 | KY | N | Nursing Service Providers | Registered Nurse | 367500000X | 051592 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 000000321769 | 01 | OH | ANTHEM OF OHIO | OTHER | P00252043 | 01 | OH | RR MCR | OTHER | 200100500 | 05 | IN | MEDICAID | 2503482 | 05 | OH | MEDICAID |