Individual provider Active NPI

Michele Hubert Waldron, CRNA

  • Certified Registered Nurse Anesthetist
  • Shelby TWP, MI
National Provider Identifier
1427025477
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704136171 Issued in MI
Practice address
47700 Robin St
Shelby TWP, MI 48317-2458
Phone
(586) 419-4493
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2019

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 4704136171 MI Primary

Addresses

Primary practice location

47700 Robin St
Shelby TWP, MI 48317-2458

Mailing address

47700 Robin St
Shelby TWP, MI 48317-2458
Phone (586) 419-4493

Other identifiers 2

IdentifierTypeStateIssuer
4593678MedicaidMI
430F364420OtherMIBCBSM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040609000087 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072596378 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ambulatory Anesthesia Associates PCGroup PAC ID 5092729020, 27 clinicians

Practice addresses (Care Compare)

230 W Maple Rd
Troy, MI 48084-5471
Phone (248) 244-1500

6240 Rashelle Dr
Suite 101
Flint, MI 48507-3938
Phone (810) 600-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704136171MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Straith Hospital for Special Surgery Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2016 Accepting new patients
Straith Hospital for Special Surgery CurrentSince Dec 1, 2016 Accepting new patients
The Digestive Endoscopy Center of Michigan LLC Current Accepting new patients
The Digestive Endoscopy Center of Michigan LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2019 Accepting new patients
Ambulatory Anesthesia Associates, PC Nurse Anesthetist, Certified Registered CurrentSince Jan 10, 2017 Accepting new patients
Straith Hospital for Special Surgery Current Accepting new patients
Gastrointestinal Specialists PC PastSince Jan 1, 1995 Accepting new patients
Straith Hospital for Special Surgery Past Accepting new patients

Locations

6240 Rashelle Dr
Ste 101
Flint, MI 48507
Phone (810) 600-4000

23901 Lahser Rd
Southfield, MI 48033
Phone (248) 357-3360

230 W Maple Rd
Troy, MI 48084
Phone (248) 244-1500

33545 Cherry Hill Rd
#O
Westland, MI 48186
Phone (734) 729-7960

33545 Cherry Hill Rd
Westland, MI 48186
Phone (734) 595-1166

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1427025477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47700 ROBIN ST",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483172458",
            "telephone_number": "586-419-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47700 ROBIN ST",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483172458",
            "telephone_number": "586-419-4493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRON",
        "first_name": "MICHELE",
        "middle_name": "HUBERT",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704136171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4593678",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "430F364420",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.