Individual provider Active NPI

Michael Kent Perry, CRNA

  • Certified Registered Nurse Anesthetist
  • Omaha, NE
National Provider Identifier
1255428439
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
100507 Issued in NE
Practice address
8031 W Center Rd
Suite 226
Omaha, NE 68124-3134
Phone
(402) 391-8978
Fax
(402) 391-8979
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2012

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 100507 NE Primary
Certified Registered Nurse Anesthetist 367500000X D-067145 IA

Addresses

Primary practice location

8031 W Center Rd
Suite 226
Omaha, NE 68124-3134

Mailing address

13811 Charles St
Omaha, NE 68154-3883
Phone (402) 492-8544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040827000392 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113992793 Reassigns benefits to 1 organization
I20051013000187 NE Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113992793 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D-067145IAMDCertified Registered Nurse Anesthetist
100507NEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Management PC Nurse Anesthetist, Certified Registered CurrentSince Aug 17, 1996 Accepting new patients
Comprehensive Pain Center Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1840 Madison Ave
Ste 4
Council Bluffs, IA 51503
Phone (712) 256-0515

2301 Eastern Ave
Red Oak, IA 51566
Phone (712) 623-7270

1423 7th St
Aurora, NE 68818
Phone (402) 694-3171

217 E Stolley Park Rd
Ste K
Grand Island, NE 68801
Phone (308) 380-0669

8031 W Center Rd
Ste 226
Omaha, NE 68124
Phone (402) 305-9986

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GIFFBA

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1255428439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13811 CHARLES ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681543883",
            "telephone_number": "402-492-8544",
            "fax_number": "402-391-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8031 W CENTER RD",
            "address_2": "SUITE 226",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681243134",
            "telephone_number": "402-391-8978",
            "fax_number": "402-391-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "MICHAEL",
        "middle_name": "KENT",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "100507",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D-067145",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.