Individual provider Active NPI

Jamie Michelle Kirby, CRNA

  • Certified Registered Nurse Anesthetist
  • Fairfax, VA
National Provider Identifier
1598060121
Registry record updated Jul 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024171083 Issued in VA
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

Updated by the provider on Jul 9, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
PENDINGMedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110302000812 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527240118 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians

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

LicenseStateTypeSpecialty
4704253902MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Asa Staffing Inc Nurse Anesthetist, Certified Registered CurrentSince Aug 8, 2020 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 21, 2022 Accepting new patients
Southfield Rehabilitation Company Nurse Anesthetist, Certified Registered CurrentSince Jul 20, 2020 Accepting new patients
Southfield Rehabilitation Company CurrentSince Jul 20, 2020 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.

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": "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.

Verify at the official NPI Registry.