Individual provider Active NPI

Kathleen L O'Shea, CRNA

  • Certified Registered Nurse Anesthetist
  • Grand Blanc, MI
National Provider Identifier
1619083086
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704155821 Issued in MI
Practice address
1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone
(810) 606-6499
Fax
(810) 606-7245
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 4704155821 MI Primary

Addresses

Primary practice location

1 Genesys Pkwy
Grand Blanc, MI 48439-8065

Mailing address

2432 Genesys Pkwy
Grand Blanc, MI 48439-8069
Phone (810) 606-6499

Other identifiers 1

IdentifierTypeStateIssuer
4465650MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081217000443 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365504875 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Anesthesia PLLCGroup PAC ID 8628471190, 37 clinicians

Practice addresses (Care Compare)

1701 S Blvd E
Suite 300
Rochester Hills, MI 48307-6120
Phone (248) 844-9710

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704155821MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Macomb Endoscopy Center, PLC CurrentSince Jan 10, 2019 Accepting new patients
Henry Ford Health Genesys Hospital Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2008 Accepting new patients
Surgical Centers of Michigan, LLC CurrentSince Jan 10, 2019 Accepting new patients
Ascension Genesys Hospital CurrentSince Jul 1, 2008 Accepting new patients
Macomb Endoscopy Center PLC Current Accepting new patients
Pinnacle Anesthesia PLLC CurrentSince Aug 1, 2021 Accepting new patients
Surgical Centers of Michigan, LLC. Current Accepting new patients

Locations

7794 Solution Ctr
Chicago, IL 60677

1 Genesys Pkwy
#H
Grand Blanc, MI 48439

1 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-5733

1707 Lake Lansing Rd
Lansing, MI 48912
Phone (517) 267-0033

48801 Romeo Plank Rd
Ste 101
Macomb, MI 48044
Phone (586) 726-8423

1701 South Blvd E
Ste 300
Rochester Hills, MI 48307
Phone (248) 844-9710

50438 Van Dyke Ave
Shelby Township, MI 48317
Phone (586) 726-8423

4600 Investment Dr
Ste 270
Troy, MI 48098
Phone (248) 267-6222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619083086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2432 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398069",
            "telephone_number": "810-606-6499",
            "fax_number": "810-606-7245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-6499",
            "fax_number": "810-606-7245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SHEA",
        "first_name": "KATHLEEN",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704155821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4465650",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.