Individual provider Active NPI

Mika Stilwell, CRNA

  • Certified Registered Nurse Anesthetist
  • Salem, VA
National Provider Identifier
1750041208
Registry record updated Dec 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
136105 Issued in VA
Practice address
1900 Electric Rd
Salem, VA 24153-7474
Phone
(866) 788-9852
NPI assigned
Dec 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2021

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 136105 VA Primary

Addresses

Primary practice location

1900 Electric Rd
Salem, VA 24153-7474

Mailing address

3038 Burnleigh Rd SW
Roanoke, VA 24014-4204

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220314001667 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214322015 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acv IncGroup PAC ID 3870633936, 70 clinicians

Practice addresses (Care Compare)

5115 Bernard Dr
Suite 201
Roanoke, VA 24018-4367
Phone (540) 345-0289

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
136105VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Acv Inc CurrentSince Nov 12, 2024 Accepting new patients
Valley Anesthesia PC CurrentSince Feb 1, 2022 Accepting new patients
Anesthesiology Consultants of Virginia, Inc PastSince Nov 12, 2024 Accepting new patients

Locations

3700 S Main St
Blacksburg, VA 24060
Phone (540) 951-1111

5115 Bernard Dr
Ste 201
Roanoke, VA 24018
Phone (540) 345-0289

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

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.

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": "1640476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640476800000",
    "number": "1750041208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3038 BURNLEIGH RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240144204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 ELECTRIC RD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537474",
            "telephone_number": "866-788-9852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILWELL",
        "first_name": "MIKA",
        "name_prefix": "Dr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-26",
        "last_updated": "2021-12-26",
        "certification_date": "2021-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "136105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2021; 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.