NPIMap

Organization Active NPI

Miycrnas LLC

  • Certified Registered Nurse Anesthetist
  • Southfield, MI
National Provider Identifier
1255915757
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
MIYCRNAS LLC
Practice address
29201 Telegraph Rd
Southfield, MI 48034-1331
Phone
(281) 248-0028
NPI assigned
May 11, 2021
Last updated
May 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Authorized official

Name
Kenny Lee, CRNANPI 1124456538
Title
Owner
Phone
(248) 797-9839

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

29201 Telegraph Rd
Southfield, MI 48034-1331

Mailing address

2351 Yorkshire Rd
Birmingham, MI 48009-5919
Phone (248) 797-9839

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210518000629 MI Part B Supplier - Clinic/Group Practice 4981013257 Receives reassigned benefits from 19 practitioners
Practice locations: Southfield, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620691200000",
    "number": "1255915757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 YORKSHIRE RD",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480095919",
            "telephone_number": "248-797-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29201 TELEGRAPH RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341331",
            "telephone_number": "281-248-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIYCRNAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-797-9839",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.