Individual provider Active NPI

Rebecca Jean Maxwell, CRNA

  • Certified Registered Nurse Anesthetist
  • Saginaw, MI
National Provider Identifier
1609153139
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704230260 Issued in MI
Practice address
1447 N Harrison St
Saginaw, MI 48602-4727
Phone
(989) 583-0000
NPI assigned
Nov 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

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 4704230260 MI Primary

Addresses

Primary practice location

1447 N Harrison St
Saginaw, MI 48602-4727

Mailing address

1447 N Harrison St
Saginaw, MI 48602-4727
Phone (989) 583-0000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120120000046 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 8729255484 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Center, Inc.Group PAC ID 2769387778, 488 clinicians

Practice addresses (Care Compare)

700 Cooper Ave
Saginaw, MI 48602-5383
Phone (989) 791-0452

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc CurrentSince Nov 7, 2011 Accepting new patients
Covenant Medical Center, Inc. Nurse Anesthetist, Certified Registered CurrentSince Nov 7, 2011 Accepting new patients
Waterford Anesthesia, PLLC CurrentSince Jun 3, 2013 Accepting new patients
Waterford Surgical Center, LLC Past Accepting new patients

Locations

1546 Callis Rd
Lapeer, MI 48446
Phone (810) 667-4000

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

700 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6000

5220 Highland Rd
Ste 1
Waterford, MI 48327
Phone (248) 886-5555

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": "1320969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1609153139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 N HARRISON ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024727",
            "telephone_number": "989-583-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1447 N HARRISON ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024727",
            "telephone_number": "989-583-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "REBECCA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-11",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704230260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; 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.