Individual provider Active NPI

Lindsay Ann Lepore, CRNA

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
National Provider Identifier
1528394996
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704248019 Issued in MI
Practice address
4201 Saint Antoine St
Detroit, MI 48201-2153
Phone
(313) 745-3407
NPI assigned
Oct 20, 2009
Last updated
Dec 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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 4704248019 MI Primary

Addresses

Primary practice location

4201 Saint Antoine St
Detroit, MI 48201-2153

Mailing address

Department 4676
Carol Stream, IL 60122-4676
Phone (952) 442-9770

Other identifiers 1

IdentifierTypeStateIssuer
LS248019OtherBLUE CROSS

Other names 1

  • Lindsay A Shotwell Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100122000198 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062554405 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Michigan PLLCGroup PAC ID 9638481591, 192 clinicians

Practice addresses (Care Compare)

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 745-3615

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704248019MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2015 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 19, 2021 Accepting new patients

Locations

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Organizations & group practices 3

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": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1528394996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT 4676",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601224676",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-3407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEPORE",
        "first_name": "LINDSAY",
        "middle_name": "ANN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704248019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "LS248019",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "SHOTWELL",
            "middle_name": "A",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; 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.