Individual provider Active NPI

Jessica Lightbody, CRNA

  • Certified Registered Nurse Anesthetist
  • Plymouth, MI
National Provider Identifier
1730502261
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704272398 Issued in MI
Practice address
40777 Ann Arbor Rd E
Plymouth, MI 48170-4448
Phone
(800) 653-6568
Fax
(313) 876-1305
NPI assigned
Feb 4, 2014
Last updated
Mar 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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 4704272398 MI Primary

Addresses

Primary practice location

40777 Ann Arbor Rd E
Plymouth, MI 48170-4448

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (800) 853-6568

Other practice location 1

2601 Electric Ave
Port Huron, MI 48060-6587
Phone (810) 985-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140331001251 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769613066 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
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)

39450 W 12 Mile Rd
Novi, MI 48377-3600
Phone (248) 344-8080

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704272398MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Rochester Hospital CurrentSince Jan 1, 2021 Accepting new patients
Henry Ford Health Rochester Hospital Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients
Henry Ford Health Macomb Oakland Hospital Nurse Anesthetist, Certified Registered CurrentSince Mar 20, 2017 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Mar 20, 2017 Accepting new patients
Henry Ford Health System Nurse Anesthetist, Certified Registered CurrentSince Mar 6, 2023 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital Nurse Anesthetist, Certified Registered CurrentSince Mar 20, 2017 Accepting new patients
Northstar Anesthesia of Michigan PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2015 Accepting new patients
Henry Ford Health System CurrentSince Mar 6, 2023 Accepting new patients

Locations

7560 Solutions Ctr
Chicago, IL 60677

7920 Solutions Ctr Dr
Chicago, IL 60677

7924 Solutions Ctr Dr
Chicago, IL 60677

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

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

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

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

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

39450 W Twelve Mile Rd
Novi, MI 48377
Phone (248) 344-2300

40777 Ann Arbor Rd E
Plymouth, MI 48170
Phone (734) 738-2073

1101 W University Dr
Rochester Hls, MI 48307
Phone (248) 601-4805

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4
  • Direct secure messaging: juban840432@direct.hfhs.org

Organizations & group practices 8

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1730502261",
    "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",
            "telephone_number": "800-853-6568",
            "fax_number": "313-876-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40777 ANN ARBOR RD E",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704448",
            "telephone_number": "800-653-6568",
            "fax_number": "313-876-1305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 Electric Ave",
            "address_purpose": "LOCATION",
            "city": "Port Huron",
            "state": "MI",
            "postal_code": "480606587",
            "country_code": "US",
            "telephone_number": "810-985-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIGHTBODY",
        "first_name": "JESSICA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-04",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704272398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.