Individual provider Active NPI

Mandy Rutter, APRN CRNA

  • Certified Registered Nurse Anesthetist
  • Escanaba, MI
National Provider Identifier
1063781623
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704375031 Issued in MI
Practice address
3401 Ludington St
Escanaba, MI 49829-1300
Phone
(906) 786-5707
NPI assigned
Dec 27, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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 4704375031 MI Primary

Addresses

Primary practice location

3401 Ludington St
Escanaba, MI 49829-1300

Mailing address

8303 M.5 Rd
Gladstone, MI 49837-9081
Phone (501) 350-6420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120220000460 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860650066 Reassigns benefits to 4 organizations
I20210528001086 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860650066 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Michigan-Alpena PLLCGroup PAC ID 6406260124, 25 clinicians

Practice addresses (Care Compare)

1721 S Stephenson Ave
Iron Mountain, MI 49801-3637
Phone (906) 774-1313

3401 Ludington St
Escanaba, MI 49829-1300
Phone (906) 786-5707

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704375031MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Michigan-Alpena PLLC Nurse Anesthetist, Certified Registered CurrentSince May 18, 2021 Accepting new patients
Aspirus Keweenaw CurrentSince Feb 28, 2022 Accepting new patients
Norton Crna PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2017 Accepting new patients
Drumright Community Hospital LLC CurrentSince Feb 1, 2021 Accepting new patients
Aspirus Keweenaw CurrentSince Feb 28, 2022 Accepting new patients
Aspirus Keweenaw Current Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2019 Accepting new patients
Hatton Anesthesia LLC PastSince Aug 1, 2017 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

3401 Ludington St
Escanaba, MI 49829
Phone (906) 786-3311

205 Osceola St
Laurium, MI 49913
Phone (906) 337-3100

610 W Bypass
Drumright, OK 74030
Phone (918) 382-2300

10512 N 110th East Ave
Owasso, OK 74055
Phone (918) 272-1172

111 N Bailey St
Pryor, OK 74361
Phone (918) 824-7791

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

8803 S 101st East Ave
Tulsa, OK 74133
Phone (918) 250-2033

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Organizations & group practices 9

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 2

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": "1324944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1063781623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8303 M.5 RD",
            "city": "GLADSTONE",
            "state": "MI",
            "postal_code": "498379081",
            "telephone_number": "501-350-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 LUDINGTON ST",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498291300",
            "telephone_number": "906-786-5707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTTER",
        "first_name": "MANDY",
        "credential": "APRN CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-27",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704375031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escanaba, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; 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.