Individual provider Active NPI

Stacey E Brown-Fortune

  • Certified Registered Nurse Anesthetist
  • Ann Arbor, MI
National Provider Identifier
1730627399
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704273738 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
Feb 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 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 4704273738 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170224000644 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507140217 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Ohio Medical University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

Practice addresses (Care Compare)

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000

4270 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (734) 936-4000

Hospital & facility affiliations

  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704273738MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Nurse Anesthetist, Certified Registered CurrentSince Jan 23, 2017 Accepting new patients
Henry Ford Health System CurrentSince Jan 23, 2017 Accepting new patients
PSJ Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2022 Accepting new patients
Regents of the University of Michigan Nurse Anesthetist, Certified Registered CurrentSince Jun 13, 2023 Accepting new patients
Michigan Crnas Staffing LLC CurrentSince Jun 1, 2019 Accepting new patients
Regents of the University of Michigan CurrentSince Jun 13, 2023 Accepting new patients

Locations

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

4270 Plymouth Rd
Ann Arbor, MI 48109
Phone (734) 232-3000

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

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

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

43422 W Oaks Dr
Novi, MI 48377
Phone (248) 229-4658

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

Interoperability endpoints

  • Direct secure messaging: sbrownfortune14172@direct.hfhs.org

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": "1486080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1730627399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2799 W Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022608",
            "country_code": "US",
            "telephone_number": "313-916-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN-FORTUNE",
        "first_name": "STACEY",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-03",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704273738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.