Kelly Large

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704281314 Issued in MI

Practice address

54460 Blue Cloud Dr
Shelby TWP, MI 48315-1226

Phone

(586) 703-3018

NPI assigned

Sep 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health Rochester HospitalGroup PAC ID 8820994098, 104 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Rochester Hospital Hospital, Rochester, MI, CCN 230254

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4
• Direct secure messaging: klarge1135777@direct.hfhs.org

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.

• Henry Ford Health Rochester Hospital

  • Certified Registered Nurse Anesthetist
  • Rochester, MI
  • NPI 1235252321

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Asa Staffing Inc

  • Certified Registered Nurse Anesthetist
  • Rochester, MI
  • NPI 1114378981

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• PSJ Anesthesia PC

  • Certified Registered Nurse Anesthetist
  • Southfield, MI
  • NPI 1275905796

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Henry Ford Health Rochester Hospital

  • Family Medicine Physician
  • Rochester, MI
  • NPI 1184747263
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health Rochester Hospital

  • General Acute Care Hospital
  • Rochester, MI
  • NPI 1437176203
  Care Compare affiliation

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

{
    "created_epoch": "1473897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1558819805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54460 BLUE CLOUD DR",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483151226",
            "telephone_number": "586-703-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54460 BLUE CLOUD DR",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483151226",
            "telephone_number": "586-703-3018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARGE",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-15",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704281314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Puja Kumari, PTA
• Konnor Kuppe
• L Van Ameyde DDS, PC
• Kara Marie Landum, MEDICAL ASSISTANT
• Linda Ross Lane, PT
• Laura McMahon MD PC
• Laurice Adele, LLC
• Izabela Lebioda
• John W Lee, M.D.
• Legacy Partners PC

• Certified Registered Nurse Anesthetist in Shelby TWP, MI
• Providers in Shelby TWP, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.