Individual provider Active NPI

Beverly Crandell Hutchinson, APRN, BC

  • Family Nurse Practitioner
  • Iron Mountain, MI
National Provider Identifier
1396763736
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704142802 Issued in MI
Practice address
325 E H St
Iron Mountain, MI 49801
Phone
(906) 774-3300
NPI assigned
Jul 17, 2006
Last updated
Dec 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2005010462 MI
Family Nurse Practitioner 363LF0000X 4704142802 MI Primary
Registered Nurse 163W00000X 4704142802 MI
Licensed Practical Nurse 164W00000X 4704142802 MI

Addresses

Primary practice location

325 E H St
Iron Mountain, MI 49801

Mailing address

325 E H St
Iron Mountain, MI 49801-4760
Phone (906) 774-3300

Other practice location 1

220 W. Washington St. Suite 430
Marquette, MI 49855
Phone (906) 228-3655

Other identifiers 2

IdentifierTypeStateIssuer
4845354MedicaidMI
300207909OtherMITAX ID

Other names 1

  • Beverly Crandell-Hutchinson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704142802MIMDRegistered Nurse
2005010462MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Richard C Weiermiller Jr M D PLLC Current Accepting new patients
Upper Peninsula Association of Rural Health Services, Inc. Past Accepting new patients
HPCN Past Accepting new patients

Locations

1055 South Blvd E
Ste 220
Rochester Hills, MI 48307
Phone (248) 817-2230

Organizations & group practices 3

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1396763736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 E H ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498014760",
            "telephone_number": "906-774-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E H ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "49801",
            "telephone_number": "906-774-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 W. Washington St. Suite 430",
            "address_purpose": "LOCATION",
            "city": "Marquette",
            "state": "MI",
            "postal_code": "49855",
            "country_code": "US",
            "telephone_number": "906-228-3655",
            "fax_number": "231-722-1827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUTCHINSON",
        "first_name": "BEVERLY",
        "middle_name": "CRANDELL",
        "name_prefix": "Ms.",
        "credential": "APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "2005010462",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704142802",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704142802",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4704142802",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4845354",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "300207909",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEVERLY",
            "last_name": "CRANDELL-HUTCHINSON",
            "credential": "FNP, BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Iron Mountain, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; 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.