Active NPI
Michael Lee Robinson, CRNA
- Certified Registered Nurse Anesthetist
- Gallup, NM
National Provider Identifier
1295723963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- CRNA00640
- Practice address
- 516 E. Nizhoni Blvd.
Gallup, NM 87301-1337 - Phone
- (505) 722-1000
- Fax
- (505) 722-1421
- NPI assigned
- Oct 7, 2005
- Last updated
- Mar 28, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 42812 | AZ | |
| Certified Registered Nurse Anesthetist | 367500000X | CRNA00640 | NM | Primary |
Addresses
Primary practice location
516 E. Nizhoni Blvd.
Gallup, NM 87301-1337
Mailing address
P.O. Box 1337
Gallup, NM 87305-1337
Phone (505) 722-1000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G8108 | Medicaid | NM | |
| 697782 | Medicaid | AZ | |
| 97352080 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42812 | AZ | MD | Certified Registered Nurse Anesthetist |
| CRNA00640 | NM | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332892800000",
"number": "1295723963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 1337",
"city": "GALLUP",
"state": "NM",
"postal_code": "873051337",
"telephone_number": "505-722-1000",
"fax_number": "505-722-1421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 E. NIZHONI BLVD.",
"city": "GALLUP",
"state": "NM",
"postal_code": "873011337",
"telephone_number": "505-722-1000",
"fax_number": "505-722-1421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBINSON",
"first_name": "MICHAEL",
"middle_name": "LEE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-07",
"last_updated": "2012-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AZ",
"license": "42812",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NM",
"license": "CRNA00640",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G8108",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "697782",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "97352080",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gallup, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.