Michael Johnson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704223453 Issued in MI

Practice address

14700 Lake Shore Dr
Charlevoix, MI 49720-1931

Phone

(231) 547-4024

Fax

(231) 547-8088

NPI assigned

Oct 20, 2006

Sex

Male

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

Medicare fee-for-service enrollment

Enrolled in MI, AZ2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Guide Anesthesia Az LLCGroup PAC ID 1355846106, 102 clinicians

Anesthesia Partners and Management LLCGroup PAC ID 9931429198, 151 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Anesthesia Partners & Management LLC

  • Certified Registered Nurse Anesthetist
  • Brighton, MI
  • NPI 1336530997

  AZ, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Guide Anesthesia Az LLC

  • Certified Registered Nurse Anesthetist
  • Phoenix, AZ
  • NPI 1649164849

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Sleepsmith Staffing LLC

  • Certified Registered Nurse Anesthetist
  • Flint, MI
  • NPI 1114463379

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Ascend Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Mesa, AZ
  • NPI 1407642945

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1114000668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14700 LAKE SHORE DR",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201931",
            "telephone_number": "231-547-4024",
            "fax_number": "231-547-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 LAKE SHORE DR",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201931",
            "telephone_number": "231-547-4024",
            "fax_number": "231-547-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704223453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD STATE LICENSE",
            "identifier": "MJ223453",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary A Ivey, M.D.
• James a Gels MD PC
• James Jeakle, M.D.
• Molly A Jeakle, DPT
• William F Jerome, D.D.S, M.S.
• Samantha Johnstone
• Tayler Hope Jones, PHARMD
• Dennis M Joy, M.D.
• Elizabeth Ann Kaelson, DDS
• Dennis J Kan, LLBSW

• Certified Registered Nurse Anesthetist in Charlevoix, MI
• Providers in Charlevoix, 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 Aug 12, 2019; 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.