NPIMap

Organization Active NPI

William Beaumont Hospital - Crna

  • Anesthesiology Physician
  • Grosse Pointe, MI
National Provider Identifier
1306261391
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
1060000043 Issued in MI
Legal business name
WILLIAM BEAUMONT HOSPITAL - CRNA
Practice address
468 Cadieux Rd
Beaumont Grosse Pointe Crna
Grosse Pointe, MI 48230-1507
Phone
(313) 473-1000
NPI assigned
Feb 27, 2014
Organization subpart
Yes
Parent organization
WILLIAM BEAUMONT HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Authorized official

Name
Lee Ann Odom
Title
President Shared Services
Phone
(947) 522-3326

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X 1060000043 MI Primary

Addresses

Primary practice location

468 Cadieux Rd
Beaumont Grosse Pointe Crna
Grosse Pointe, MI 48230-1507

Mailing address

26901 Beaumont Blvd
Compliance
Southfield, MI 48033-4716
Phone (947) 522-1964

Other practice location 1

28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone (248) 471-8889

Other practice location 2

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-5000

Other practice location 3

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-5000

Other names 1

  • Beaumont Health CRNA Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.beaumont.edu

National Provider Directory

National Provider Directory
Tax ID family
William Beauont Hospital118 organizations share this tax ID, including this one
Part of
William Beauont Hospital

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1306261391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "address_2": "COMPLIANCE",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334716",
            "telephone_number": "947-522-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 CADIEUX RD",
            "address_2": "BEAUMONT GROSSE POINTE CRNA",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482301507",
            "telephone_number": "313-473-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28050 Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483365919",
            "country_code": "US",
            "telephone_number": "248-471-8889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44201 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851117",
            "country_code": "US",
            "telephone_number": "248-964-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736712",
            "country_code": "US",
            "telephone_number": "248-898-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WILLIAM BEAUMONT HOSPITAL - CRNA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLIAM BEAUMONT HOSPITAL",
        "enumeration_date": "2014-02-27",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "ODOM",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT SHARED SERVICES",
        "authorized_official_telephone_number": "947-522-3326"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "1060000043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "468 Cadieux Rd",
            "address_2": "Beaumont Grosse Pointe CRNA",
            "city": "Grosse Pointe",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482301507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Beaumont Health CRNA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grosse Pointe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.