NPIMap

Organization Active NPI

Beaumont West Bloomfield ASC LLC

  • Certified Registered Nurse Anesthetist
  • W Bloomfield, MI
National Provider Identifier
1275790206
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
BEAUMONT WEST BLOOMFIELD ASC LLC
Practice address
6900 Orchard Lake Rd
Ll100
W Bloomfield, MI 48322-3405
Phone
(248) 406-2400
Fax
(248) 406-2401
NPI assigned
May 19, 2008
Last updated
May 19, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
BEAUMONT WEST BLOOMFIELD ASC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Authorized official

Name
Karen Connolly, RN
Title
Project Coordinator
Phone
(248) 798-3200

Specialties & licenses 1

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

Addresses

Primary practice location

6900 Orchard Lake Rd
Ll100
W Bloomfield, MI 48322-3405

Mailing address

6900 Orchard Lake Rd
Ll100
W Bloomfield, MI 48322-3405
Phone (248) 406-2400

National Provider Directory

National Provider Directory
Part of
Beaumont West Bloomfield ASC LLC

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 49

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 49

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1275790206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 ORCHARD LAKE RD",
            "address_2": "LL100",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223405",
            "telephone_number": "248-406-2400",
            "fax_number": "248-406-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 ORCHARD LAKE RD",
            "address_2": "LL100",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223405",
            "telephone_number": "248-406-2400",
            "fax_number": "248-406-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUMONT WEST BLOOMFIELD ASC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEAUMONT WEST BLOOMFIELD ASC LLC",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "CONNOLLY",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "PROJECT COORDINATOR",
        "authorized_official_telephone_number": "248-798-3200",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in W Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.