Individual provider Active NPI

Louisa Rankin, AA-C

  • Anesthesiologist Assistant
  • Traverse City, MI
National Provider Identifier
1205240090
Registry record updated Jun 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
7202 Issued in GA
Practice address
4100 Park Forest Dr
Suite 210
Traverse City, MI 49684-7331
Phone
(231) 935-5770
Fax
(231) 935-0747
NPI assigned
Jun 19, 2014
Last updated
Jun 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 7202 GA Primary

Addresses

Primary practice location

4100 Park Forest Dr
Suite 210
Traverse City, MI 49684-7331

Mailing address

4100 Park Forest Dr
Suite 210
Traverse City, MI 49684-7331
Phone (231) 935-5770

Other names 1

  • Louisa Shu Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160831001444 MI Practitioner - Anesthesiology Assistant 0143448662 Reassigns benefits to 2 organizations
I20250219000243 OH Practitioner - Anesthesiology Assistant 0143448662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Medical GroupGroup PAC ID 8820277015, 191 clinicians
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

4100 Park Forest Dr
Traverse City, MI 49684-7331
Phone (231) 392-8900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7202GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
A4 of Ohio, LLC Anesthesiologist Assistant CurrentSince Jan 1, 2025 Accepting new patients
Munson Medical Group CurrentSince Sep 16, 2022 Accepting new patients
Munson Medical Group CurrentSince Sep 16, 2022 Accepting new patients
Munson Medical Center CurrentSince Feb 1, 2025 Accepting new patients
Munson Medical Group Current Accepting new patients
Munson Medical Center CurrentSince Feb 1, 2025 Accepting new patients
Toledo Clinic Incorporated Past Accepting new patients

Locations

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1105 Sixth St
Ste 103
Traverse City, MI 49684
Phone (231) 935-6455

1200 Sixth St
Ste 200
Traverse City, MI 49684

4100 Park Forest Dr
Traverse City, MI 49684
Phone (231) 392-8900

4100 Park Forest Dr
Ste 210
Traverse City, MI 49684
Phone (231) 935-5770

5959 Monclova Rd
Maumee, OH 43537
Phone (419) 251-3740

3330 Meijer Dr
#1
Toledo, OH 43617
Phone (419) 578-5020

4235 Secor Rd
Toledo, OH 43623
Phone (419) 214-4214

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": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1205240090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR",
            "address_2": "SUITE 210",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847331",
            "telephone_number": "231-935-5770",
            "fax_number": "231-935-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR",
            "address_2": "SUITE 210",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847331",
            "telephone_number": "231-935-5770",
            "fax_number": "231-935-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANKIN",
        "first_name": "LOUISA",
        "name_prefix": "Mrs.",
        "credential": "AA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "7202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOUISA",
            "last_name": "SHU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; 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.