Individual provider Active NPI

Jenny Ann Beauregard, CRNA

  • Certified Registered Nurse Anesthetist
  • Warren, MI
National Provider Identifier
1720064934
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704107072 Issued in MI
Practice address
21230 Dequindre Rd
Warren, MI 48091-2279
Phone
(313) 837-9651
NPI assigned
Dec 20, 2005
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 4704107072 MI Primary

Addresses

Primary practice location

21230 Dequindre Rd
Warren, MI 48091-2279

Mailing address

14820 Artesian St
Detroit, MI 48223-2229
Phone (313) 837-9651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
74.5 of 100Reported as group
Quality
70
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704107072MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ambulatory Anesthesia Associates, PC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2006 Accepting new patients
PSJ Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Nov 17, 2016 Accepting new patients
Alliance Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 17, 2019 Accepting new patients
Resource Anesthesiology Associates of Mi PC CurrentSince Jan 15, 2018 Accepting new patients
Straith Hospital for Special Surgery Past Accepting new patients
Anesthesia Office Consultants, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
St. Joseph Mercy Hospital Crna Group Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

4800 S Saginaw St
Ste 1845
Flint, MI 48507
Phone (810) 275-9152

6245 Inkster Rd
Garden City, MI 48135
Phone (734) 421-3300

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

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

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

230 W Maple Rd
Troy, MI 48084
Phone (248) 244-1500

21230 Dequindre Rd
Warren, MI 48091
Phone (586) 427-1000

33545 Cherry Hill Rd
#O
Westland, MI 48186
Phone (734) 729-7960

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720064934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14820 ARTESIAN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482232229",
            "telephone_number": "313-837-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21230 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480912279",
            "telephone_number": "313-837-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUREGARD",
        "first_name": "JENNY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704107072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, 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 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.