Individual provider Active NPI

Lisa McDonough, CRNA

  • Certified Registered Nurse Anesthetist
  • Midland, MI
National Provider Identifier
1427331032
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704263838 Issued in MI
Practice address
4000 Wellness Dr
Midland, MI 48670-6831
Phone
(989) 839-3000
NPI assigned
Sep 21, 2011
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 4704263838 MI Primary

Addresses

Primary practice location

4000 Wellness Dr
Midland, MI 48670-6831

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000
Phone (989) 839-3000

Other practice location 1

1900 Columbus Ave
Bay City, MI 48708-6831
Phone (989) 894-3795

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111108000677 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7517130511 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Center, Inc.Group PAC ID 2769387778, 488 clinicians

Practice addresses (Care Compare)

1447 N Harrison St
Saginaw, MI 48602-4727
Phone (989) 583-6237

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc. Nurse Anesthetist, Certified Registered CurrentSince Jun 14, 2017 Accepting new patients
Mymichigan Medical Center Saginaw Nurse Anesthetist, Certified Registered CurrentSince Nov 7, 2017 Accepting new patients
Mymichigan Medical Center Saginaw CurrentSince Nov 7, 2017 Accepting new patients
Covenant Medical Center, Inc CurrentSince Jun 14, 2017 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Jan 1, 2017 Accepting new patients
Mymichigan Medical Center Midland Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2017 Accepting new patients

Locations

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

700 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6000

800 S Washington Ave
Saginaw, MI 48601
Phone (989) 776-8000

L4355
Columbus, OH 43260

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1427331032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000",
            "telephone_number": "989-839-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486706831",
            "telephone_number": "989-839-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Columbus Ave",
            "address_purpose": "LOCATION",
            "city": "Bay City",
            "state": "MI",
            "postal_code": "487086831",
            "country_code": "US",
            "telephone_number": "989-894-3795",
            "fax_number": "989-891-8172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "LISA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704263838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.