Individual provider Active NPI

Scott Stone, CRNA

  • Certified Registered Nurse Anesthetist
  • Traverse City, MI
National Provider Identifier
1013233360
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704281331 Issued in MI
Practice address
4100 Park Forest Dr
Suite 210
Traverse City, MI 49684-7331
Phone
(231) 935-5770
Fax
(231) 935-0747
NPI assigned
Apr 12, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 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 4704281331 MI Primary

Addresses

Primary practice location

4100 Park Forest Dr
Suite 210
Traverse City, MI 49684-7331

Mailing address

4100 Park Forest Dr
Suite 210
Traverse City, MI 49684-7331
Phone (231) 935-5770

Other identifiers 1

IdentifierTypeStateIssuer
1013233360MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110328000632 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527199181 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Healthcare Charlevoix HospitalGroup PAC ID 4284528035, 57 clinicians
Munson Healthcare CadillacGroup PAC ID 6305161514, 104 clinicians
Kalkaska Memorial Health CenterGroup PAC ID 3577536002, 57 clinicians
Munson Healthcare Otsego Memorial HospitalGroup PAC ID 8325942535, 126 clinicians

Practice addresses (Care Compare)

14700 Lake Shore Dr
Charlevoix, MI 49720-1931
Phone (231) 547-4024

400 Hobart St
Cadillac, MI 49601-2331
Phone (231) 876-3876

419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7500

825 N Ctr Ave
Gaylord, MI 49735-1592
Phone (989) 731-2201

Hospital & facility affiliations

  • Charlevoix Area Hospital Hospital, Charlevoix, MI, CCN 231322
  • Munson Healthcare Cadillac Hospital Hospital, Cadillac, MI, CCN 230081
  • Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Charlevoix Hospital Current Accepting new patients
Munson Healthcare Cadillac Nurse Anesthetist, Certified Registered CurrentSince Jun 18, 2018 Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Jun 22, 2019 Accepting new patients
Munson Healthcare Cadillac CurrentSince Jun 18, 2018 Accepting new patients
Munson Healthcare Charlevoix Hospital CurrentSince Aug 26, 2020 Accepting new patients
Munson Healthcare Charlevoix Hospital Nurse Anesthetist, Certified Registered CurrentSince Aug 26, 2020 Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital Nurse Anesthetist, Certified Registered CurrentSince Jun 22, 2019 Accepting new patients
Munson Healthcare Cadillac Past Accepting new patients
Portsmouth Anesthesia Associates, P.C. Past Accepting new patients

Locations

3775 Momentum Pl
Chicago, IL 60689

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

14700 Lake Shore Dr
Charlevoix, MI 49720
Phone (231) 547-3840

829 N Center Ave
Ste 210
Gaylord, MI 49735
Phone (989) 731-7860

825 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

419 S Coral St
Kalkaska, MI 49646
Phone (231) 258-7500

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Organizations & group practices 12

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 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": "1271030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1013233360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR",
            "address_2": "SUITE 210",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847331",
            "telephone_number": "231-935-5770",
            "fax_number": "231-935-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR",
            "address_2": "SUITE 210",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847331",
            "telephone_number": "231-935-5770",
            "fax_number": "231-935-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONE",
        "first_name": "SCOTT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-12",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704281331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013233360",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; 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.