Individual provider Active NPI

Vercina Ie'Sheila-Denessa Powell, CRNA

  • Certified Registered Nurse Anesthetist
  • Ann Arbor, MI
National Provider Identifier
1760088371
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704300121 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
Dec 9, 2020
Last updated
Oct 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.455995 OH
Certified Registered Nurse Anesthetist 367500000X 4704300121 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

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4491

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220104000842 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840605200 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 Wall St
Ann Arbor, MI 48105-1912
Phone (734) 936-4000

14050 Dix Toledo Rd
Southgate, MI 48195-2501
Phone (734) 281-0100

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN.455995OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Anesthesia Consultants, PLLC CurrentSince Feb 13, 2024 Accepting new patients
Regents of the University of Michigan Nurse Anesthetist, Certified Registered CurrentSince Sep 28, 2021 Accepting new patients
Metropolitan Anesthesia Consultants, PLLC CurrentSince Feb 13, 2024 Accepting new patients
Regents of the University of Michigan CurrentSince Sep 28, 2021 Accepting new patients

Locations

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

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

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

14050 Toledo Dix Rd
Southgate, MI 48195
Phone (734) 281-0100

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000

Organizations & group practices 4

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.

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": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1760088371",
    "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": "2142 N Cove Blvd",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436063895",
            "country_code": "US",
            "telephone_number": "419-291-4491",
            "fax_number": "419-479-6905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "VERCINA",
        "middle_name": "IE'SHEILA-DENESSA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-09",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.455995",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704300121",
            "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 Oct 5, 2022; 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.