Active NPI
Kathy L Boyd, CRNA
- Certified Registered Nurse Anesthetist
- Traverse City, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 4704256562
- Practice address
- 4100 Park Forest Dr
Suite 210
Traverse City, MI 49684-7331 - Phone
- (231) 935-5770
- NPI assigned
- May 3, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | RN262430 | MA | |
| Certified Registered Nurse Anesthetist | 367500000X | 4704256562 | MI | Primary |
| Acute Care Nurse Practitioner | 363LA2100X | 4704256562 | MI |
Addresses
Primary practice location
4100 Park Forest Dr
Suite 210
Traverse City, MI 49684-7331
Mailing address
4100 Park Forest Dr
Suite 210
Traverse City, MI 49684-7331
Phone (231) 935-5770
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110092776A | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Northwestern University Feinberg Medical School, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1215 E Michigan Ave
Lansing, MI 48912-1811
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN262430 | MA | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edward W Sparrow Hospital Association | Current | Accepting new patients | |
| Pinnacle Anesthesia PLLC | Current | Accepting new patients | |
| Edward W. Sparrow Hospital Association | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Boston Emergency Physician Foundation, Inc. | Past | Accepting new patients | |
| Lake Lansing ASC Partners LLC | Past | Accepting new patients |
Locations
8175 Reliable Pkwy
Chicago, IL 60686
1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080
1707 Lake Lansing Rd
Lansing, MI 48912
Phone (517) 267-0033
1701 South Blvd E
Ste 300
Rochester Hills, MI 48307
Phone (248) 844-9710
50438 Van Dyke Ave
Shelby Township, MI 48317
Phone (586) 726-8423
Organizations & group practices 5
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.
-
dba Sparrow CRNA Services
- Anesthesiology Physician
- Lansing, MI
- NPI 1366498107
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Macomb, MI
- NPI 1295301133
-
dba University of Michigan Health-Sparrow
- Adult Health Nurse Practitioner
- Lansing, MI
- NPI 1265220438
-
dba Lansing Surgical Center
- Ambulatory Surgical Clinic/Center
- Lansing, MI
- NPI 1790886372
-
- Emergency Medicine Physician
- Boston, MA
- NPI 1427005859
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba University of Michigan Health-Sparrow Lansing
- General Acute Care Hospital
- Lansing, MI
- NPI 1073588711
-
dba Thoracic Cardiovascular Institute
- General Acute Care Hospital
- Lansing, MI
- NPI 1760710719
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644364800000",
"number": "1396004834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 PARK FOREST DR",
"address_2": "SUITE 210",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496847331",
"telephone_number": "231-935-5770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 PARK FOREST DR",
"address_2": "SUITE 210",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496847331",
"telephone_number": "231-935-5770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "KATHY",
"middle_name": "L",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-03",
"last_updated": "2022-02-09",
"certification_date": "2022-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MA",
"license": "RN262430",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MI",
"license": "4704256562",
"primary": true
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MI",
"license": "4704256562",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110092776A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.