Individual provider Active NPI

Wanda Lowery-Lamb, CRNA

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
National Provider Identifier
1730166356
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704171189 Issued in MI
Practice address
4201 Saint Antoine St
Detroit, MI 48201-2153
Phone
(952) 442-9770
Fax
(952) 442-3630
NPI assigned
Dec 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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 4704171189 MI Primary

Addresses

Primary practice location

4201 Saint Antoine St
Detroit, MI 48201-2153

Mailing address

Dept 203401
PO Box 67000
Detroit, MI 48267-0001
Phone (952) 442-9770

Other identifiers 2

IdentifierTypeStateIssuer
WL171189OtherMIBLUE CROSS OF MI
104300201MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060124000447 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173547684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

14500 Hall Rd
Sterling Heights, MI 48313-1229
Phone (586) 247-2700

19401 Hubbard Dr
Dearborn, MI 48126-2641
Phone (313) 982-8100

2799 W Grand Blvd
Detroit, MI 48202-2608

2799 W Grand Boulevard
Detroit, MI 48202-2608
Phone (313) 916-2600

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2005 Accepting new patients
Henry Ford Health System CurrentSince Oct 10, 2005 Accepting new patients
Crnas of Michigan Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

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

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

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

Interoperability endpoints

  • Direct secure messaging: wlowery5074@direct.hfhs.org

Organizations & group practices 3

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": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286409600000",
    "number": "1730166356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 203401",
            "address_2": "PO BOX 67000",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670001",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWERY-LAMB",
        "first_name": "WANDA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-23",
        "last_updated": "2010-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704171189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MI",
            "identifier": "WL171189",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104300201",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "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 Oct 7, 2010; 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.