Provider Demographics
NPI:1770526063
Name:CAPUTO, JOHN BATTISTA II (CRNA)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:BATTISTA
Last Name:CAPUTO
Suffix:II
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 ASHMORE DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-9659
Mailing Address - Country:US
Mailing Address - Phone:304-677-2444
Mailing Address - Fax:
Practice Address - Street 1:1200 J D ANDERSON DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3494
Practice Address - Country:US
Practice Address - Phone:800-394-4445
Practice Address - Fax:706-650-1034
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV58730367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015497300001Medicaid
MD405883600Medicaid
OH2663381Medicaid
WV2601339000Medicaid
WV001706470OtherMSBCBS
WV001718914OtherMSBCBS
WVDA0096OtherRR MEDICARE
MD405883600Medicaid
WV001718914OtherBCBS AAP NUMBER
WV0207026000Medicaid
WV205542387OtherAAP TRI CARE NUMBER
WVP00167741OtherRR MEDICARE
WV270052997004OtherTRICARE
OH2663381Medicaid
WV20554238700OtherWORKERS COMP
WV27005299701OtherWORKERS COMP
WV20554238700OtherWORKERS COMP
WVP00167741OtherRR MEDICARE
WV8232813Medicare PIN
WVP00167741OtherRR MEDICARE
WV270052997004OtherTRICARE
WV20554238700OtherWORKERS COMP