Kenneth L Guy Jr. | NPI 1134716012

Key facts

NPI: 1134716012
Entity type: Individual (NPI type 1)
Primary specialty: Certified Registered Nurse Anesthetist 367500000X
License: 4704299199 (MI)
Practice address: 6225 North State Hwy 161 Ste 200
Irving, TX 75038-2241
Phone: (214) 687-1000
NPI assigned: Dec 28, 2020
Sex: Male
Sole proprietor: No

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 and National Provider Directory roles.

Northstar Anesthesia of Michigan III PLLC Pain Medicine (Anesthesiology) Physician · Irving, TX · NPI 1972126209

Medicare reassignment Care Compare group NPD MI · NURSE ANESTHETIST, CERTIFIED REGISTERED
Anupama Shah MD, PLC Pain Medicine (Anesthesiology) Physician · Monroe, MI · NPI 1679864623

Medicare reassignment NPD MI
Stephen J. Watts, MD, PLLC Gastroenterology Physician · Wyandotte, MI · NPI 1548352412

NPD (past)

Hospital & facility affiliations 1

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

Oakwood Healthcare, Inc. General Acute Care Hospital · Trenton, MI · NPI 1740230648

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Certified Registered Nurse Anesthetist (Crna)
Education: Other, 2020
Medicare assignment: May accept Medicare assignment
Group practices: Northstar Anesthesia of Michigan III PLLC (561 clinicians)

Practice addresses (Care Compare)

33155 Annapolis St
Wayne, MI 48184-2405
Phone (214) 687-0001

5450 Fort St
Trenton, MI 48183-4601
Phone (214) 687-0001

Hospital & facility affiliations

Corewell Health Trenton Hospital Hospital · Trenton, MI · CCN 230176

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MI

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20210329000680	MI	Practitioner - Certified Registered Nurse Anesthetist (Crna)	7416364054	Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Certified Registered Nurse

Practice roles

Organization	Specialty	Status	New patients
Northstar Anesthesia of Michigan III PLLC	Nurse Anesthetist, Certified Registered	Current since Feb 15, 2021	Accepting new patients
Anupama Shah MD, PLC		Current since Mar 1, 2022	Accepting new patients
Stephen J. Watts, MD, PLLC		Past	Accepting new patients

Locations

1051 S Telegraph Rd
Ste 10
Monroe, MI 48161
Phone (734) 244-5383

1051 S Telegraph Rd
Ste 100
Monroe, MI 48161
Phone (734) 244-5383

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

6225 State Highway 161
Ste 200
Irving, TX 75038
Phone (214) 687-0496

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Certified Registered Nurse Anesthetist	367500000X	4704299199	MI	Yes

Addresses

Primary practice location

6225 North State Hwy 161 Ste 200
Irving, TX 75038-2241

Mailing address

24613 Fairlawn Dr
Flat Rock, MI 48134-2768
Phone (734) 626-9949

Other providers in Irving, TX

All providers in Irving, TX · Certified Registered Nurse Anesthetist in Texas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.