Active NPI
John Pemberton, CRNA
- Certified Registered Nurse Anesthetist
- West Bloomfield, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 4704327563
- Practice address
- 6777 W Maple Rd
West Bloomfield, MI 48322-3013 - Phone
- (586) 286-0050
- NPI assigned
- May 16, 2023
- Last updated
- Jul 16, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 4704327563 | MI | Primary |
| Registered Nurse | 163W00000X | 4704327563 | MI |
Addresses
Primary practice location
6777 W Maple Rd
West Bloomfield, MI 48322-3013
Mailing address
1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-4806
Other practice location 1
23491 Norwood St
Oak Park, MI 48237-2203
Phone (248) 495-9694
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
28050 Grand River Ave
Farmington Hills, MI 48336-5933
Phone (947) 522-1860
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 98.54 of 100
- Quality
- 93.24
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.69
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704327563 | MI | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Botsford General Hospital | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Botsford General Hospital | Current | Accepting new patients | |
| Northstar Anesthesia of Michigan III PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
28050 Grand River Ave
Farmington Hills, MI 48336
Phone (248) 471-8000
33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042
Organizations & group practices 3
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.
-
- Certified Registered Nurse Anesthetist
- Farmington Hills, MI
- NPI 1235179664
Nurse Anesthetist, Certified Registered
-
- Pain Medicine (Anesthesiology) Physician
- Irving, TX
- NPI 1972126209
MI, Nurse Anesthetist, Certified Registered
-
dba Midwest Urgent Care
- Urgent Care Clinic/Center
- Redford, MI
- NPI 1831402056
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Beaumont Hospital-Farmington Hills
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
-
dba Internal Medicine Associates Farmington Hills
- Internal Medicine Physician
- Farmington Hills, MI
- NPI 1538103395
Hospital
-
dba Botsford Thoracic Surgery Clinic
- Internal Medicine Physician
- Farmington Hills, MI
- NPI 1912335373
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784160000000",
"number": "1093406514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 FORD PL STE 3A",
"city": "DETROIT",
"state": "MI",
"postal_code": "482023450",
"telephone_number": "313-874-4806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6777 W MAPLE RD",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483223013",
"telephone_number": "586-286-0050"
}
],
"practiceLocations": [
{
"address_1": "23491 Norwood St",
"address_purpose": "LOCATION",
"city": "Oak Park",
"state": "MI",
"postal_code": "482372203",
"country_code": "US",
"telephone_number": "248-495-9694",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEMBERTON",
"first_name": "JOHN",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-16",
"last_updated": "2026-07-16",
"certification_date": "2026-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MI",
"license": "4704327563",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704327563",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Bloomfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.