Individual provider Active NPI

Jeannine Dahl, CRNA

  • Certified Registered Nurse Anesthetist
  • Farmington Hills, MI
National Provider Identifier
1013256916
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704225099 Issued in MI
Practice address
31923 Bella Vista Dr
Farmington Hills, MI 48334-2827
Phone
(734) 673-5097
NPI assigned
Feb 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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 4704225099 MI Primary

Addresses

Primary practice location

31923 Bella Vista Dr
Farmington Hills, MI 48334-2827

Mailing address

31923 Bella Vista Dr
Farmington Hills, MI 48334-2827
Phone (734) 673-5097

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130329000099 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254576937 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608

2799 W Grand Boulevard
Detroit, MI 48202-2608
Phone (313) 916-2600

6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-4100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford West Bloomfield Hospital Nurse Anesthetist, Certified Registered CurrentSince Feb 2, 2013 Accepting new patients
Henry Ford West Bloomfield Hospital CurrentSince Feb 2, 2013 Accepting new patients
Henry Ford Health System Nurse Anesthetist, Certified Registered CurrentSince Feb 7, 2013 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 21, 2022 Accepting new patients
William Beaumont Hospital Nurse Anesthetist, Certified Registered CurrentSince Jun 11, 2015 Accepting new patients
William Beaumont Hospital CurrentSince Jun 11, 2015 Accepting new patients
Henry Ford Health System CurrentSince Feb 7, 2013 Accepting new patients

Locations

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

3601 W 13 Mile Rd
Royal Oak, MI 48073

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

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

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: jdahl4242@direct.hfhs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1360627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360627200000",
    "number": "1013256916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31923 BELLA VISTA DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342827",
            "telephone_number": "734-673-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31923 BELLA VISTA DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342827",
            "telephone_number": "734-673-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "JEANNINE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-12",
        "last_updated": "2013-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704225099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.