Individual provider Active NPI

Henry Michael McElroy, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, WY
National Provider Identifier
1003937137
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
20027.0743 Issued in WY
Practice address
625 E Broadway Ave
Jackson, WY 83001-8642
Phone
(307) 739-7218
Fax
(307) 739-7446
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 20027.0743 WY Primary

Addresses

Primary practice location

625 E Broadway Ave
Jackson, WY 83001-8642

Mailing address

PO Box 428
Jackson, WY 83001-0428
Phone (307) 739-7218

Other identifiers 1

IdentifierTypeStateIssuer
115612800MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20027.0743WYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Wyoming Pathology, Inc Past Accepting new patients
Anesthesia Services of Jacksonhole, P.C. Past Accepting new patients
Grand Anesthesiology Services PC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1003937137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830010428",
            "telephone_number": "307-739-7218",
            "fax_number": "307-739-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E BROADWAY AVE",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018642",
            "telephone_number": "307-739-7218",
            "fax_number": "307-739-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCELROY",
        "first_name": "HENRY",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WY",
            "license": "20027.0743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115612800",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.