Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

PHILLIP NICODEMUS CRNA
NPI 1417917899
Anesthesiology in Martinsburg, WV

Active since March 28, 2006
94 OLD MILL RD, MARTINSBURG, WV 25401(304) 264-8933(304) 264-8846 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Phillip Nicodemus Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHILLIP NICODEMUS CRNA (NPI 1417917899) is an individual anesthesiology provider in Martinsburg, West Virginia, licensed in West Virginia (33379) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1417917899
Entity TypeIndividualMale
Primary Taxonomy207L00000X
Provider Legal NamePHILLIP NICODEMUSCredential: CRNA
Location Address94 OLD MILL RDMartinsburg, WV 25401-9284
Mailing Address94 Old Mill RdMartinsburg, WV 25401-9284 · (304) 264-8933 · Fax (304) 264-8846
Fax(304) 264-8846
Sole ProprietorNo
Enumeration DateMarch 28, 2006
Last NPPES UpdateJuly 13, 2026
NPI 1417917899 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License Licensed in WV · 33379
Definition

An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.

94 OLD MILL RD, Martinsburg, WV 25401

Other Identifiers 1

Medicaid0068750000WV

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Anesthesiology (Pain Medicine)
94 OLD MILL RD
MARTINSBURG, WV 25401
Psychologist (Clinical)
94 OLD MILL RD
MARTINSBURG, WV 25401
Anesthesiology
94 OLD MILL RD
MARTINSBURG, WV 25401
Anesthesiology
94 OLD MILL RD
MARTINSBURG, WV 25401
Anesthesiology (Pain Medicine)
94 OLD MILL RD
MARTINSBURG, WV 25401
Obstetrics & Gynecology
94 OLD MILL RD
MARTINSBURG, WV 25401
Anesthesiology
94 OLD MILL RD
MARTINSBURG, WV 25401
Psychologist (Clinical)
94 OLD MILL RD
MARTINSBURG, WV 25401

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phillip Nicodemus's NPI number?

The NPI number for Phillip Nicodemus is 1417917899. It was assigned to this individual provider in the NPPES registry on March 28, 2006.

Where is Phillip Nicodemus located?

Phillip Nicodemus practices at 94 Old Mill Rd, Martinsburg, WV 25401. The listed phone number is (304) 264-8933.

What is Phillip Nicodemus's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

When was this NPI record last updated?

The NPPES record for Phillip Nicodemus was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.