Carmen G Kislov, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704210733 Issued in MI

Practice address

33155 Annapolis St
Wayne, MI 48184-2405

Phone

(734) 467-4667

Fax

(734) 467-2303

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carmen G Blan Former name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Group practices

Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Corewell Health Wayne Hospital Hospital, Wayne, MI, CCN 230142

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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.

• Northstar Anesthesia of Michigan III PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Irving, TX
  • NPI 1972126209

  MI, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Center for Digestive Care LLC

  • Ambulatory Surgical Clinic/Center
  • Ypsilanti, MI
  • NPI 1164528527
  Medicare reassignment NPD
• Chelsea Community Hospital

  • Certified Registered Nurse Anesthetist
  • Chelsea, MI
  • NPI 1568542967

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Chelsea Community Hospital

  • Urgent Care Clinic/Center
  • Chelsea, MI
  • NPI 1033778733
  NPD
• Detroit Osteopathic Hospital Corporation

  dba Henry Ford Macomb Hospital - Warren Campus

  • Certified Registered Nurse Anesthetist
  • Warren, MI
  • NPI 1336182351

  Nurse Anesthetist, Certified Registered

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Oakwood Healthcare, Inc.

  dba Beaumont Hospital - Wayne

  • General Acute Care Hospital
  • Wayne, MI
  • NPI 1295785285
  Care Compare affiliation

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063599876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33155 ANNAPOLIS ST",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481842405",
            "telephone_number": "734-467-4667",
            "fax_number": "734-467-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33155 ANNAPOLIS ST",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481842405",
            "telephone_number": "734-467-4667",
            "fax_number": "734-467-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISLOV",
        "first_name": "CARMEN",
        "middle_name": "G",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704210733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4328730",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARMEN",
            "last_name": "BLAN",
            "middle_name": "G",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chang Choo Kim, M.D.
• Nancy Kimmel, NP
• Brittany King
• Colin F King, PHD
• Tracy Kish
• Erika N Koepke
• Charbel Rony Korab
• Janice Marie Kornacki, MA LLP
• Anastasia A Koromos, BSN RN
• Austin Henry Kovar, MA, TLLP

• Certified Registered Nurse Anesthetist in Wayne, MI
• Providers in Wayne, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.