Individual provider Active NPI

John Mitchell Hoopes, CRNA

  • Certified Registered Nurse Anesthetist
  • Portage, WI
National Provider Identifier
1356317309
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
130610 Issued in WI
Practice address
2817 New Pinery Rd
Portage, WI 53901-9240
Phone
(608) 742-4131
NPI assigned
Feb 28, 2006
Last updated
Sep 30, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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 130610 WI Primary

Addresses

Primary practice location

2817 New Pinery Rd
Portage, WI 53901-9240

Mailing address

1230 Hanover TRL
Waunakee, WI 53597-2649
Phone (608) 850-4277

Other identifiers 1

IdentifierTypeStateIssuer
44324500MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050419001096 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719925957 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2626WIMDChiropractor
130610WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation Current Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Dec 1, 2014 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Dec 1, 2014 Accepting new patients
Mercy Health System Corporation CurrentSince May 23, 2007 Accepting new patients
Mercy Health System Corporation CurrentSince May 23, 2007 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

29980 Network Pl
Chicago, IL 60673

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

900 Ridge St
Stoughton, WI 53589
Phone (608) 231-3410

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1356317309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 HANOVER TRL",
            "city": "WAUNAKEE",
            "state": "WI",
            "postal_code": "535972649",
            "telephone_number": "608-850-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY RD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019240",
            "telephone_number": "608-742-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOPES",
        "first_name": "JOHN",
        "middle_name": "MITCHELL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "130610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44324500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; 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.