NPIMap

Organization Active NPI

Lighthouse Anesthesia Staffing LLC

  • Certified Registered Nurse Anesthetist
  • Holland, MI
National Provider Identifier
1518657873
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
LIGHTHOUSE ANESTHESIA STAFFING LLC
Practice address
4625 43Rd St
Holland, MI 49423-9013
Phone
(269) 569-4587
NPI assigned
May 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Authorized official

Name
Kurt Andrew Feringa, CRNANPI 1376030411
Title
Partner
Phone
(269) 569-4587

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

4625 43Rd St
Holland, MI 49423-9013

Mailing address

5623 E Dunbar Rd
Monroe, MI 48161-9127
Phone (734) 241-3891

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230524001055 MI Part B Supplier - Clinic/Group Practice 2163888728 Receives reassigned benefits from 5 practitioners
Practice locations: Muskegon, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683676800000",
    "number": "1518657873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5623 E DUNBAR RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481619127",
            "telephone_number": "734-241-3891",
            "fax_number": "734-241-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 43RD ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494239013",
            "telephone_number": "269-569-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE ANESTHESIA STAFFING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A",
        "authorized_official_last_name": "FERINGA",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "269-569-4587",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.