Healthcare Provider Details

I. General information

NPI: 1215867254
Provider Name (Legal Business Name): PATRICK MICHAEL GARVEY CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 W BROAD ST
COLUMBUS OH
43228-1607
US

IV. Provider business mailing address

68 STONE HENGE DR
GRANVILLE OH
43023-9267
US

V. Phone/Fax

Practice location:
  • Phone: 614-544-1000
  • Fax:
Mailing address:
  • Phone: 614-531-2225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN.418635
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.0021532
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: