NPIMap

Individual provider Active NPI

Raymond L Stull

  • Certified Registered Nurse Anesthetist
  • Warren, MI
National Provider Identifier
1528198637
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704110684 Issued in MI
Practice address
13355 East 10 Mile Rd
Warren, MI 48089
Phone
(800) 543-1963
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 4704110684 MI Primary

Addresses

Primary practice location

13355 East 10 Mile Rd
Warren, MI 48089

Mailing address

4150 Heritage CT
Trenton, MI 48183-3930
Phone (734) 676-5990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Detroit Osteopathic Hospital Corporation Nurse Anesthetist, Certified Registered Past Accepting new patients
Monroe Community Health Services Nurse Anesthetist, Certified Registered Past Accepting new patients
Garden City Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Crnas of Michigan Nurse Anesthetist, Certified Registered Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rstull220821@direct.hfhs.org
  • FHIR API: https://phsfhir.primehealthcare.com/PHS-PRD-FHIR/api/FHIR/R4

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528198637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 HERITAGE CT",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481833930",
            "telephone_number": "734-676-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13355 EAST 10 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48089",
            "telephone_number": "800-543-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STULL",
        "first_name": "RAYMOND",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704110684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.