Individual provider Active NPI

Caitlin Mary Pemberton

  • Certified Registered Nurse Anesthetist
  • Flint, MI
National Provider Identifier
1700421864
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704351620 Issued in MI
Practice address
303 E Kearsley St
Flint, MI 48502-1907
Phone
(810) 762-3300
NPI assigned
Nov 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 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 AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X 4704351620 MI Primary

Addresses

Primary practice location

303 E Kearsley St
Flint, MI 48502-1907

Mailing address

6985 Springcrest CT
Clarkston, MI 48346-1075
Phone (810) 691-2239

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cpemberton95903@direct.hurleymc.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221004000697 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355727033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hurley Medical CenterGroup PAC ID 2961308481, 336 clinicians

Practice addresses (Care Compare)

1 Hurley PLZ
Flint, MI 48503-5902
Phone (810) 262-9353

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.4 of 100Reported as group
Quality
66.97
Promoting interoperability
100
Improvement activities
40
Cost
75.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704351620MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates Inc PC Single Specialty Current Accepting new patients
Hurley Medical Center Single Specialty CurrentSince Oct 1, 2022 Accepting new patients
Hurley Medical Center Single Specialty CurrentSince Oct 1, 2022 Accepting new patients
Hurley Medical Center Single Specialty Current Accepting new patients
Hurley Medical Center Single Specialty Past Accepting new patients
Hurley Medical Center Single Specialty Past Accepting new patients

Locations

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

1 Hurley Plz
#4N
Flint, MI 48503
Phone (810) 262-9284

Organizations & group practices 6

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 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": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1700421864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6985 SPRINGCREST CT",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483461075",
            "telephone_number": "810-691-2239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E KEARSLEY ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485021907",
            "telephone_number": "810-762-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMBERTON",
        "first_name": "CAITLIN",
        "middle_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704351620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpemberton95903@direct.hurleymc.com",
            "affiliation": "N",
            "address_1": "1 Hurley Plz # 4N",
            "city": "Flint",
            "state": "MI",
            "country_code": "US",
            "postal_code": "485035902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.