Individual provider Active NPI

Paul Richard Emmons III, CRNA

  • Certified Registered Nurse Anesthetist
  • Trenton, MI
National Provider Identifier
1003178377
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704260929 Issued in MI
Practice address
5450 Fort St
Trenton, MI 48183-4601
Phone
(734) 671-3800
NPI assigned
Jun 13, 2012
Last updated
Nov 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704260929 MI Primary
Certified Registered Nurse Anesthetist 367500000X 4018129 KY

Addresses

Primary practice location

5450 Fort St
Trenton, MI 48183-4601

Mailing address

1865 Baldwin CT
Trenton, MI 48183-1908
Phone (734) 306-6953

Other practice location 1

800 Rose St
Lexington, KY 40536-0293
Phone (859) 323-5956

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pemmons114164@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121018000363 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608026117 Reassigns benefits to 4 organizations
I20251208000783 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608026117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians
University of KentuckyGroup PAC ID 3072425289, 778 clinicians

Practice addresses (Care Compare)

5450 Fort St
Trenton, MI 48183-4601
Phone (214) 687-0001

5640 N Adrian Hwy
Adrian, MI 49221-8318
Phone (419) 291-4491

800 Rose St
Lexington, KY 40536-7001
Phone (859) 257-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
4018129KYMDCertified Registered Nurse Anesthetist
4704260929MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Memorial Hospital Corporation Nurse Anesthetist, Certified Registered CurrentSince Jan 2, 2019 Accepting new patients
Mercy Memorial Hospital Corporation CurrentSince Jan 2, 2019 Accepting new patients
Northstar Anesthesia of Michigan II PC Nurse Anesthetist, Certified Registered CurrentSince Sep 14, 2016 Accepting new patients
Promedica Central Corporation of Michigan CurrentSince May 31, 2023 Accepting new patients
University of Kentucky CurrentSince Nov 24, 2025 Accepting new patients
Michigan Crnas Staffing LLC CurrentSince Jul 25, 2018 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 20, 2020 Accepting new patients

Locations

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

5640 N Adrian Hwy
Adrian, MI 49221
Phone (419) 291-3000

818 Riverside Ave
Adrian, MI 49221
Phone (517) 263-0711

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

3175 Smith Rd
Lambertville, MI 48144
Phone (734) 856-5494

1707 Lake Lansing Rd
Lansing, MI 48912
Phone (517) 267-0033

3400 E Jolly Rd
Lansing, MI 48910
Phone (517) 272-1063

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

26750 Providence Pkwy
Ste 100
Novi, MI 48374
Phone (248) 662-1500

43422 W Oaks Dr
Novi, MI 48377
Phone (248) 229-4658

200 E Russell Rd
Unit C
Tecumseh, MI 49286
Phone (517) 424-3883

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

5450 Fort St
Woodhaven, MI 48183
Phone (734) 671-3297

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1003178377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 BALDWIN CT",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481831908",
            "telephone_number": "734-306-6953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 FORT ST",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481834601",
            "telephone_number": "734-671-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Rose St",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360293",
            "country_code": "US",
            "telephone_number": "859-323-5956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMMONS",
        "first_name": "PAUL",
        "middle_name": "RICHARD",
        "name_suffix": "III",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-13",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704260929",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "4018129",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pemmons114164@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Trenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; 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.

Verify at the official NPI Registry.