Nicole Black, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

139623 Issued in MI

Practice address

5301 McAuley Dr
Ypsilanti, MI 48197-1051

Phone

(734) 712-3456

NPI assigned

Dec 24, 2021

Sex

Female

Sole proprietor

No

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.

• Sjmhs Anesthesia Services

  • Anesthesiology Physician
  • Howell, MI
  • NPI 1215026281

  MI

  Medicare reassignment Care Compare group NPD
• Sjmhs Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • Ypsilanti, MI
  • NPI 1184069874

  Nurse Anesthetist, Certified Registered

  NPD
• Sjmhs Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • Brighton, MI
  • NPI 1205271996

  Nurse Anesthetist, Certified Registered

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Mercy Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443

  Hospital

  Care Compare affiliation

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sjmhs Anesthesia Services 103 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1640304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640304000000",
    "number": "1376203802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E FOREST AVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481983075",
            "telephone_number": "517-375-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 MCAULEY DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "NICOLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-24",
        "last_updated": "2021-12-24",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "139623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Birks, LMSW
• Casey Bishop
• Jade Bishop, LLMSW
• Richard Alfred Bishop, PHARMACIST
• David Martin Black, M.D.
• Jennifer Diane Blackburn, MSW
• Sean Joseph Novara Blackburn, MD
• Alexander Blank
• Julie Blasko, MA, CCC-SLP, CBIS
• Jeanette Blassic, PA-C

• All providers in Ypsilanti, MI
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2021; 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.