Individual provider Active NPI

Robert Carter, CRNA, RN

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
National Provider Identifier
1669989836
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704295699 Issued in MI
Practice address
6071 W Outer Dr
Detroit, MI 48235-2624
Phone
(313) 966-6077
NPI assigned
Jan 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704295699 MI
Certified Registered Nurse Anesthetist 367500000X 4704295699 MI Primary

Addresses

Primary practice location

6071 W Outer Dr
Detroit, MI 48235-2624

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5922

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rcarter167080@epicdirect.promedica.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180208001312 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880954080 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Michigan Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians
Promedica Central Corporation of MichiganGroup PAC ID 7012902265, 112 clinicians

Practice addresses (Care Compare)

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000

200 E Russell Rd
Unit C
Tecumseh, MI 49286-2072
Phone (517) 263-9491

4270 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (734) 936-4000

5640 N Adrian Hwy
Adrian, MI 49221-8318
Phone (419) 291-4491

Hospital & facility affiliations

  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046
  • Promedica Charles and Virginia Hickman Hospital Hospital, Adrian, MI, CCN 230005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704295699MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan II PC Nurse Anesthetist, Certified Registered CurrentSince Aug 9, 2018 Accepting new patients
Huron Gastroenterology Associates PC CurrentSince Jun 1, 2021 Accepting new patients
Promedica Central Corporation of Michigan CurrentSince Nov 18, 2022 Accepting new patients
Northstar Anesthesia of Michigan PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 15, 2018 Accepting new patients
Huron Gastroenterology Associates PC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2021 Accepting new patients
Sjmhs Anesthesia Services Nurse Anesthetist, Certified Registered CurrentSince Jun 3, 2019 Accepting new patients
Sjmhs Anesthesia Services Nurse Anesthetist, Certified Registered Current Accepting new patients
Center for Digestive Care LLC CurrentSince Dec 1, 2018 Accepting new patients
Regents of the University of Michigan CurrentSince Sep 14, 2021 Accepting new patients
Sjmhs Anesthesia Services Current Accepting new patients
Regents of the University of Michigan Nurse Anesthetist, Certified Registered CurrentSince Sep 14, 2021 Accepting new patients

Locations

777 Kimole Ln
Ste 220
Adrian, MI 49221
Phone (517) 263-6464

818 Riverside Ave
Adrian, MI 49221
Phone (517) 263-0711

4270 Plymouth Rd
Ann Arbor, MI 48109
Phone (734) 232-3000

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

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

3400 E Jolly Rd
Lansing, MI 48910
Phone (517) 272-1063

26750 Providence Pkwy
Ste 100
Novi, MI 48374
Phone (248) 662-1500

200 E Russell Rd
Unit C
Tecumseh, MI 49286
Phone (517) 424-3883

5300 Elliott Dr
Ypsilanti, MI 48197
Phone (734) 434-6262

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

135 S Prospect St
Ypsilanti, MI 48198
Phone (734) 547-1060

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

6225 State Highway 161
Ste 200
Irving, TX 75038
Phone (214) 687-0496

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 11

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.

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": "1515456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1669989836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352624",
            "telephone_number": "313-966-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "ROBERT",
        "credential": "CRNA, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-09",
        "last_updated": "2023-11-03",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704295699",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704295699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcarter167080@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.