Active NPI
Kimberly Dawn Harris, CRNA
- Certified Registered Nurse Anesthetist
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 4704169677
- Practice address
- 3990 John R St
Detroit, MI 48201-2018 - Phone
- (313) 745-8521
- NPI assigned
- May 27, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 4704169677 | MI | Primary |
Addresses
Primary practice location
3990 John R St
Detroit, MI 48201-2018
Mailing address
PO Box 67000
Dept 203401
Detroit, MI 48267-0002
Phone (888) 278-4126
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone (810) 987-5000
4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 745-3615
Hospital & facility affiliations
- Harper University Hospital
- Karmanos Cancer Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704169677 | MI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radius Anesthesia of Michigan PLLC | Current | Accepting new patients | |
| Asa Staffing Inc | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Northstar Anesthesia of Michigan PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000
1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500
6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300
3990 John R St
Detroit, MI 48201
Phone (313) 745-6211
4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615
50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300
1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300
31235 Harper Ave
St Clr Shores, MI 48082
Phone (267) 817-8902
111 Town Square Pl
Ste 420
Jersey City, NJ 07310
Phone (201) 258-4700
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/ynC9J_dODQE9MboiEOzSXwBNhdrTWHFe/
- https://fhir-myrecord.cerner.com/r4/65462acd-8903-4686-b436-2e6d88ad8c3c/
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Certified Registered Nurse Anesthetist
- Rochester, MI
- NPI 1114378981
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Irving, TX
- NPI 1871986372
MI, Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Saint Clair Shores, MI
- NPI 1578002523
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1316900277
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1427360700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277683200000",
"number": "1003041617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 67000",
"address_2": "DEPT 203401",
"city": "DETROIT",
"state": "MI",
"postal_code": "482670002",
"telephone_number": "888-278-4126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3990 JOHN R ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012018",
"telephone_number": "313-745-8521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "KIMBERLY",
"middle_name": "DAWN",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-27",
"last_updated": "2010-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MI",
"license": "4704169677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.