Active NPI
Jamie Michelle Kirby, CRNA
- Certified Registered Nurse Anesthetist
- Fairfax, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 0024171083
- Practice address
- 3998 Fair Ridge Dr
Suite 320
Fairfax, VA 22033-2907 - Phone
- (703) 295-9360
- Fax
- (703) 295-9369
- NPI assigned
- Jan 12, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 4704253902 | MI | |
| Certified Registered Nurse Anesthetist | 367500000X | 0024171083 | VA | Primary |
Addresses
Primary practice location
3998 Fair Ridge Dr
Suite 320
Fairfax, VA 22033-2907
Mailing address
PO Box 37090
Baltimore, MD 21297-3090
Phone (703) 295-9360
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2010
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
44201 Dequindre Rd
Nsa of Michigan III PLLC
Troy, MI 48085-1117
Phone (214) 687-0001
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704253902 | MI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Asa Staffing Inc | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Northstar Anesthesia of Michigan III PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Southfield Rehabilitation Company | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Southfield Rehabilitation Company | Current | Accepting new patients |
Locations
1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000
50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300
22401 Foster Winter Dr
Southfield, MI 48075
Phone (248) 423-4100
44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255
33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pain Medicine (Anesthesiology) Physician
- Irving, TX
- NPI 1972126209
MI, Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Rochester, MI
- NPI 1114378981
Nurse Anesthetist, Certified Registered
-
dba Surgeons Choice Medical Center
- General Acute Care Hospital
- Southfield, MI
- NPI 1790785095
Nurse Anesthetist, Certified Registered
-
dba Surgeons Choice Dearborn Center
- Diagnostic Radiology Physician
- Dearborn, MI
- NPI 1285906792
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Beaumont Hospital, Troy
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404864000000",
"number": "1598060121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 37090",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212973090",
"telephone_number": "703-295-9360",
"fax_number": "703-295-9369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3998 FAIR RIDGE DR",
"address_2": "SUITE 320",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220332907",
"telephone_number": "703-295-9360",
"fax_number": "703-295-9369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRBY",
"first_name": "JAMIE",
"middle_name": "MICHELLE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-12",
"last_updated": "2014-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MI",
"license": "4704253902",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "VA",
"license": "0024171083",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.