Individual provider Active NPI

Michael Reed, CRNA

  • Certified Registered Nurse Anesthetist
  • New London, WI
National Provider Identifier
1497837900
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
114312 Issued in WI
Practice address
1405 Mill St
New London, WI 54961
Phone
(920) 531-2000
Fax
(920) 531-2098
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 114312 WI Primary

Addresses

Primary practice location

1405 Mill St
New London, WI 54961

Mailing address

122 E College Ave
Appleton, WI 54911-5794
Phone (920) 996-3264

Other practice location 1

1515 Park Ave
Columbus, WI 53925-2402
Phone (920) 623-2200

Other practice location 2

1515 Park Ave
Columbus, WI 53925-2402
Phone (920) 623-2200

Other practice location 3

800 Riverside Dr
Waupaca, WI 54981-1943
Phone (715) 258-1000

Other practice location 4

100 County Road B
Shawano, WI 54166-7072
Phone (715) 526-2111

Other practice location 5

225 Memorial Dr
Berlin, WI 54923-1243
Phone (920) 361-5538

Other identifiers 1

IdentifierTypeStateIssuer
43385900MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040701000685 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557348125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Association of Hospital Anesthesiologists SCGroup PAC ID 3476539875, 84 clinicians

Practice addresses (Care Compare)

1405 Mill St
New London, WI 54961-2155
Phone (920) 531-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
114312WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Association of Hospital Anesthesiologists SC CurrentSince Jun 1, 2020 Accepting new patients
Laboratory Corportation of America Holdings Past Accepting new patients
Wisconsin Institute of Urology SC Past Accepting new patients
Racine Anesthesia Services, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Stevens Point Anesthesia Association, S.C. Past Accepting new patients
Southeastern Wisconsin Anesthesiology, S.C. Past Accepting new patients

Locations

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

2109 E Capitol Dr
#B
Appleton, WI 54911
Phone (844) 693-1483

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

736 Ford St
Kimberly, WI 54136

130 2nd St
#A107
Neenah, WI 54956

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

100 Cty Road B
Shawano, WI 54166
Phone (715) 524-2161

800 Riverside Dr
Waupaca, WI 54981
Phone (715) 258-1000

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1497837900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E COLLEGE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115794",
            "telephone_number": "920-996-3264",
            "fax_number": "920-830-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 MILL ST",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "54961",
            "telephone_number": "920-531-2000",
            "fax_number": "920-531-2098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "WI",
            "postal_code": "539252402",
            "country_code": "US",
            "telephone_number": "920-623-2200",
            "fax_number": "920-623-1441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "WI",
            "postal_code": "539252402",
            "country_code": "US",
            "telephone_number": "920-623-2200",
            "fax_number": "920-623-1441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Waupaca",
            "state": "WI",
            "postal_code": "549811943",
            "country_code": "US",
            "telephone_number": "715-258-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 County Road B",
            "address_purpose": "LOCATION",
            "city": "Shawano",
            "state": "WI",
            "postal_code": "541667072",
            "country_code": "US",
            "telephone_number": "715-526-2111",
            "fax_number": "715-526-9366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "WI",
            "postal_code": "549231243",
            "country_code": "US",
            "telephone_number": "920-361-5538",
            "fax_number": "920-361-5499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REED",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "114312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43385900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.