Individual provider Active NPI

Kristen Brady, MSN, RN, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, MI
National Provider Identifier
1629513072
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704279005 Issued in MI
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 205-4800
NPI assigned
Dec 21, 2016
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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 4704279005 MI Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

16481 Seymour Rd
Grass Lake, MI 49240-9289
Phone (989) 858-6916

Other practice location 1

775 S Main St
Chelsea, MI 48118-1383
Phone (734) 593-6000

Other names 1

  • Kristen Oltersdorf Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170202001659 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012290794 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chelsea Community HospitalGroup PAC ID 0648171074, 38 clinicians

Practice addresses (Care Compare)

1125 E Michigan Ave
Henry Ford Allegiance Surgery Center
Jackson, MI 49201-1801
Phone (517) 205-1080

205 N E Ave
Jackson, MI 49201-1753

205 S E Ave
Henry Ford Allegiance Digestive HLT
Jackson, MI 49201-2413
Phone (517) 205-2103

775 S Main St
Chelsea, MI 48118-1370
Phone (734) 475-1311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704279005MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Chelsea Community Hospital CurrentSince Dec 30, 2019 Accepting new patients
W.a. Foote Memorial Hospital CurrentSince Jan 11, 2017 Accepting new patients
Chelsea Community Hospital Nurse Anesthetist, Certified Registered CurrentSince Dec 30, 2019 Accepting new patients
W.a. Foote Memorial Hospital Nurse Anesthetist, Certified Registered CurrentSince Jan 11, 2017 Accepting new patients
Chelsea Community Hospital Past Accepting new patients

Locations

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

205 S East Ave
Jackson, MI 49201
Phone (517) 205-2103

Interoperability endpoints

  • Direct secure messaging: kbrady453099@direct.hfhs.org

Organizations & group practices 5

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 2

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": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1629513072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16481 SEYMOUR RD",
            "city": "GRASS LAKE",
            "state": "MI",
            "postal_code": "492409289",
            "telephone_number": "989-858-6916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "775 S Main St",
            "address_purpose": "LOCATION",
            "city": "Chelsea",
            "state": "MI",
            "postal_code": "481181383",
            "country_code": "US",
            "telephone_number": "734-593-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADY",
        "first_name": "KRISTEN",
        "credential": "MSN, RN, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704279005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "OLTERSDORF",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.