Individual provider Active NPI

Jeremie Nathan Rene, CRNA, RN

  • Certified Registered Nurse Anesthetist
  • Ann Arbor, MI
National Provider Identifier
1063158517
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704328516 Issued in MI
Practice address
1527 Long Meadow TRL
Ann Arbor, MI 48108-9633
Phone
(989) 992-5779
NPI assigned
May 9, 2022
Last updated
Dec 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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 4704328516 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X 4704328516 MI

Addresses

Primary practice location

1527 Long Meadow TRL
Ann Arbor, MI 48108-9633

Mailing address

1527 Long Meadow TRL
Ann Arbor, MI 48108-9633
Phone (989) 992-5779

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241118001476 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072047737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Mary's Health ServicesGroup PAC ID 4981500436, 175 clinicians

Practice addresses (Care Compare)

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (734) 263-2400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Mary's Health Services Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2024 Accepting new patients
Saint Mary's Health Services CurrentSince Sep 1, 2024 Accepting new patients

Locations

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

Organizations & group practices 2

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 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": "1652054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1063158517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 LONG MEADOW TRL",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481089633",
            "telephone_number": "989-992-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 LONG MEADOW TRL",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481089633",
            "telephone_number": "989-992-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENE",
        "first_name": "JEREMIE",
        "middle_name": "NATHAN",
        "credential": "CRNA, RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-09",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704328516",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4704328516",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.