Individual provider Active NPI

Amanda Ahrens, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, MI
National Provider Identifier
1093033474
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704237420 Issued in MI
Practice address
205 N East Ave
Jackson, MI 49201
Phone
(517) 788-4800
NPI assigned
May 11, 2010
Last updated
Mar 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704237420 MI
Certified Registered Nurse Anesthetist 367500000X 4704237420 MI Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201

Mailing address

PO Box 64000
Drawer 541535
Detroit, MI 48264-0001
Phone (734) 786-8052

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aahrens453098@direct.hfhs.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101108000779 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355536053 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

205 N E Ave
Jackson, MI 49201-1753

205 S E Ave
Henry Ford Allegiance Digestive HLT
Jackson, MI 49201-2413
Phone (517) 205-2103

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704237420MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Chelsea Community Hospital CurrentSince Aug 19, 2019 Accepting new patients
West Michigan Aas LLC CurrentSince Jan 1, 2022 Accepting new patients
W.a. Foote Memorial Hospital CurrentSince Jun 15, 2010 Accepting new patients
Chelsea Community Hospital Nurse Anesthetist, Certified Registered CurrentSince Aug 19, 2019 Accepting new patients
Novi Aas LLC CurrentSince Sep 1, 2021 Accepting new patients
W.a. Foote Memorial Hospital Nurse Anesthetist, Certified Registered CurrentSince Jun 15, 2010 Accepting new patients
Michigan Crnas Staffing LLC CurrentSince Sep 1, 2021 Accepting new patients

Locations

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

17000 Executive Plaza Dr
Ste 301
Dearborn, MI 48126
Phone (313) 408-6613

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-4316

4024 Park East Ct SE
Grand Rapids, MI 49546
Phone (231) 592-3102

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

205 S East Ave
Jackson, MI 49201
Phone (517) 205-2103

1030 N Monroe St
Ste 2
Monroe, MI 48162
Phone (734) 682-3309

25500 Meadowbrook Rd
Ste 110
Novi, MI 48375
Phone (248) 477-0220

43422 W Oaks Dr
Novi, MI 48377
Phone (248) 229-4658

1560 E Maple Rd
#100
Troy, MI 48083
Phone (248) 817-2001

Interoperability endpoints

  • Direct secure messaging: aahrens453098@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, 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": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1093033474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64000",
            "address_2": "DRAWER 541535",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482640001",
            "telephone_number": "734-786-8052",
            "fax_number": "734-786-4932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49201",
            "telephone_number": "517-788-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHRENS",
        "first_name": "AMANDA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-11",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704237420",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704237420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aahrens453098@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "205 N East Ave",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.