Individual provider Active NPI

John Whited, CRNA

  • Certified Registered Nurse Anesthetist
  • Bingham Farms, MI
National Provider Identifier
1437117629
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704204265 Issued in MI
Practice address
30200 Telegraph Rd
Suite 220
Bingham Farms, MI 48025-4502
Phone
(248) 258-5058
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4704204265 MI
Certified Registered Nurse Anesthetist 367500000X 4704204265 MI Primary

Addresses

Primary practice location

30200 Telegraph Rd
Suite 220
Bingham Farms, MI 48025-4502

Mailing address

22101 Moross Rd
Detroit, MI 48236-2148

Other identifiers 1

IdentifierTypeStateIssuer
104796278MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050201000600 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103730916 Reassigns benefits to 1 organization
I20050607000094 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103730916 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704204265MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital Nurse Anesthetist, Certified Registered CurrentSince Oct 20, 2019 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Oct 20, 2019 Accepting new patients
Southwest Ohio Anesthesia Consultants LLC Anesthesiology CurrentSince Jan 23, 2025 Accepting new patients
Northstar Anesthesia of Michigan II PC Anesthesiology Past Accepting new patients

Locations

7915 Solutions Ctr Dr
Chicago, IL 60677

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

2213 Cherry St
Toledo, OH 43608
Phone (419) 251-4283

Organizations & group practices 4

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1437117629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30200 TELEGRAPH RD",
            "address_2": "SUITE 220",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254502",
            "telephone_number": "248-258-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITED",
        "first_name": "JOHN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4704204265",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704204265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104796278",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bingham Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.