Individual provider Active NPI

Tamara Heaston, CRNA

  • Certified Registered Nurse Anesthetist
  • Kalamazoo, MI
National Provider Identifier
1013000462
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704140469 Issued in MI
Practice address
900 Peeler St Ste B
Kalamazoo, MI 49008-2380
Phone
(269) 345-8618
Fax
(269) 345-1508
NPI assigned
Sep 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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 4704140469 MI Primary

Addresses

Primary practice location

900 Peeler St Ste B
Kalamazoo, MI 49008-2380

Mailing address

900 Peeler St Ste B
Kalamazoo, MI 49008-2380
Phone (269) 345-8618

Other identifiers 2

IdentifierTypeStateIssuer
4704140469OtherMIMI LICENSE
07796964MedicaidCO

Other names 1

  • Tamara Riddel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200212001795 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 8820068042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center AlpenaGroup PAC ID 8527969922, 97 clinicians

Practice addresses (Care Compare)

1501 W Chisholm St
Alpena, MI 49707-1401
Phone (989) 356-7390

Hospital & facility affiliations

  • Mymichigan Medical Center Alpena Hospital, Alpena, MI, CCN 230036

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Alpena Current Accepting new patients
Joseph a. Houle MD PC Current Accepting new patients
Mymichigan Medical Center Alpena CurrentSince Feb 1, 2022 Accepting new patients
Candace W Ross PHD LLC CurrentSince Feb 2, 2020 Accepting new patients
Mymichigan Medical Center Alpena Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2022 Accepting new patients
Colorado Personnel Resources Inc Past Accepting new patients

Locations

1501 W Chisholm St
Alpena, MI 49707
Phone (989) 356-7000

900 Peeler St
Kalamazoo, MI 49008
Phone (269) 345-8618

900 Peeler St
Ste B
Kalamazoo, MI 49008
Phone (269) 345-8618

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1013000462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 PEELER ST STE B",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490082380",
            "telephone_number": "269-345-8618",
            "fax_number": "269-345-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PEELER ST STE B",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490082380",
            "telephone_number": "269-345-8618",
            "fax_number": "269-345-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEASTON",
        "first_name": "TAMARA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-30",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704140469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI LICENSE",
            "identifier": "4704140469",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07796964",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMARA",
            "last_name": "RIDDEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; 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.