Individual provider Active NPI

Michelle Keutzer, CRNA

  • Certified Registered Nurse Anesthetist
  • Mount Pleasant, SC
National Provider Identifier
1295841310
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
070455 Issued in SC
Practice address
1200 Johnnie Dodds Blvd
Mount Pleasant, SC 29464-3231
Phone
(843) 881-4323
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 070455 SC Primary

Addresses

Primary practice location

1200 Johnnie Dodds Blvd
Mount Pleasant, SC 29464-3231

Mailing address

744 W Michigan Ave
PO Box 1123
Jackson, MI 49201-1909
Phone (517) 787-6440

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140725000000 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032102850 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Medical University of South Carolina College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

530 Park Ave E
Princeton, IL 61356-3901
Phone (815) 875-2811

Hospital & facility affiliations

  • Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
  • Osf Saint Clare Medical Center Hospital, Princeton, IL, CCN 141337
  • Osf Saint Paul Medical Center Hospital, Mendota, IL, CCN 141310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070455SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Hammond Henry Dist Hospital CurrentSince Oct 15, 2014 Accepting new patients
Osf Multi-Specialty Group CurrentSince Jul 1, 2023 Accepting new patients
Hammond Henry Dist Hospital CurrentSince Oct 15, 2014 Accepting new patients
Valley Pain Care Centers LTD CurrentSince May 1, 2014 Accepting new patients
Mt. Pleasant Anesthesia Associates, PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Greenville Health System Past Accepting new patients
Beaufort County Memorial Hospital Past Accepting new patients
Hammond Henry Dist Hospital Past Accepting new patients

Locations

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

600 N College Ave
Geneseo, IL 61254
Phone (309) 944-6431

100 5th St
Oswego, IL 60543
Phone (630) 449-0085

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

925 West St
Peru, IL 61354
Phone (815) 223-3300

530 Park Ave E
Princeton, IL 61356
Phone (815) 875-2811

1879 N Neltnor Blvd
West Chicago, IL 60185

Organizations & group practices 9

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.

Hospital & facility affiliations 3

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295841310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 W MICHIGAN AVE",
            "address_2": "PO BOX 1123",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011909",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 JOHNNIE DODDS BLVD",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643231",
            "telephone_number": "843-881-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEUTZER",
        "first_name": "MICHELLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "070455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.