Individual provider Active NPI

Emily Michelle Eggleston, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, MI
National Provider Identifier
1689200123
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704302437 Issued in MI
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 205-4800
NPI assigned
Mar 17, 2020
Last updated
Oct 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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 4704302437 MI Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450

Other practice location 1

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eeggleston660049@direct.hfhs.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200731001497 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042635401 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

205 N E Ave
Henry Ford Allegiance Health
Jackson, MI 49201-1753
Phone (517) 205-4800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704302437MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Chelsea Community Hospital CurrentSince Sep 2, 2023 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Jun 29, 2020 Accepting new patients
Chelsea Community Hospital Nurse Anesthetist, Certified Registered CurrentSince Sep 2, 2023 Accepting new patients
W.a. Foote Memorial Hospital Nurse Anesthetist, Certified Registered CurrentSince Jun 29, 2020 Accepting new patients
Henry Ford Health System Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2023 Accepting new patients
Henry Ford Health System CurrentSince Mar 1, 2023 Accepting new patients

Locations

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

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

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

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

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, 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": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1689200123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450"
        },
        {
            "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": "EGGLESTON",
        "first_name": "EMILY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-17",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704302437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eeggleston660049@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "205 N East Ave",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492011753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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 Oct 2, 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.