NPIMap

Organization Active NPI

Anesthesia Professional Services PC

  • Certified Registered Nurse Anesthetist
  • Monroe, MI
National Provider Identifier
1750304622
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704142787 Issued in MI
Legal business name
ANESTHESIA PROFESSIONAL SERVICES PC
Practice address
5623 E Dunbar Rd
Monroe, MI 48161-9127
Phone
(734) 241-3891
Fax
(734) 241-0014
NPI assigned
Jul 25, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Scott Coddington, CRNANPI 1699798611
Title
Owner
Phone
(734) 241-3891

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X 4704142787 MI Primary

Addresses

Primary practice location

5623 E Dunbar Rd
Monroe, MI 48161-9127

Mailing address

5623 E Dunbar Rd
Monroe, MI 48161-9127
Phone (734) 241-3891

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040214000198 MI Part B Supplier - Clinic/Group Practice 8527952092 Receives reassigned benefits from 12 practitioners
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Locations

750 E Beltline Ave NE
Ste 201A
Grand Rapids, MI 49525
Phone (616) 942-6767

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750304622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5623 E DUNBAR RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481619127",
            "telephone_number": "734-241-3891",
            "fax_number": "734-241-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5623 E DUNBAR RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481619127",
            "telephone_number": "734-241-3891",
            "fax_number": "734-241-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIA PROFESSIONAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CODDINGTON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-241-3891",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704142787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.