Individual provider Active NPI

Thomas Hart II, RN

  • Registered Nurse
  • Okemos, MI
National Provider Identifier
1174194294
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704282982 Issued in MI
Practice address
2350 Shawnee TRL
Okemos, MI 48864-2530
Phone
(810) 813-5020
NPI assigned
Jul 9, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 139505 MI
Registered Nurse 163W00000X 4704282982 MI Primary

Addresses

Primary practice location

2350 Shawnee TRL
Okemos, MI 48864-2530

Mailing address

2350 Shawnee TRL
Okemos, MI 48864-2530
Phone (810) 813-5020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221201002165 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082082623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1210 W Saginaw St
SMG Anesthesiology
Lansing, MI 48915-1927
Phone (517) 253-3050

1215 E Michigan Ave
Lansing, MI 48912-1811

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
139505MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W. Sparrow Hospital Association Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2022 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Nov 1, 2022 Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

Organizations & group practices 2

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": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1174194294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 SHAWNEE TRL",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488642530",
            "telephone_number": "810-813-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 SHAWNEE TRL",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488642530",
            "telephone_number": "810-813-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "THOMAS",
        "name_suffix": "II",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-09",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "139505",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704282982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; 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.