Individual provider Active NPI

Tamara Davila, CRNA

  • Certified Registered Nurse Anesthetist
  • Clarkston, MI
National Provider Identifier
1760628713
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704248191 Issued in MI
Practice address
6628 College Park
Clarkston, MI 48346-1065
Phone
(248) 563-6323
NPI assigned
Dec 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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 4704248191 MI Primary

Addresses

Primary practice location

6628 College Park
Clarkston, MI 48346-1065

Mailing address

6628 College Park
Clarkston, MI 48346-1065
Phone (248) 563-6323

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090824000566 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163576299 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asa Staffing IncGroup PAC ID 3971898644, 146 clinicians
Memorial HospitalGroup PAC ID 8527976497, 210 clinicians
Anesthesia Associates of the Lower Peninsula PCGroup PAC ID 1456841865, 25 clinicians
Long Lake Anesthesiology Consultants PLCGroup PAC ID 7113818980, 94 clinicians

Practice addresses (Care Compare)

1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone (810) 987-5000

3337 Britton Rd
Perry, MI 48872-9706
Phone (517) 625-3004

4599 Towne Centre Rd
Saginaw, MI 48604-2804
Phone (734) 421-3300

5202 Miller Rd
Flint, MI 48507-1040
Phone (810) 732-7700

721 N Shiawassee St
Owosso, MI 48867-1632

826 W King St
Owosso, MI 48867-2120

Hospital & facility affiliations

  • Memorial Healthcare Hospital, Owosso, MI, CCN 230121
  • Straith Hospital for Special Surgery Hospital, Southfield, MI, CCN 230071

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Anesthetists Associates, Inc. CurrentSince Jan 16, 2018 Accepting new patients
Memorial Hospital Nurse Anesthetist, Certified Registered CurrentSince Sep 15, 2025 Accepting new patients
Henry Ford Health St. John Hospital Nurse Anesthetist, Certified Registered CurrentSince Jun 21, 2009 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Jun 21, 2009 Accepting new patients
Long Lake Anesthesiology Consultants, PLC CurrentSince Aug 1, 2024 Accepting new patients
Memorial Hospital Nurse Anesthetist, Certified Registered CurrentSince Sep 15, 2025 Accepting new patients
Asa Staffing Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 15, 2025 Accepting new patients
Memorial Hospital Past Accepting new patients
Waterford Surgical Center, LLC Past Accepting new patients

Locations

2009 Momentum Pl
Chicago, IL 60689

7915 Solutions Ctr Dr
Chicago, IL 60677

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

9000 Peet Rd
Chesaning, MI 48616
Phone (989) 720-2273

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

5202 Miller Rd
Flint, MI 48507
Phone (810) 720-8900

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

3337 Britton Rd
Perry, MI 48872
Phone (517) 625-3004

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

920 River Centre Dr
Port Huron, MI 48060
Phone (810) 984-5200

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

4550 Investment Dr
Troy, MI 48098
Phone (248) 265-4600

4550 Investment Dr
Ste 100
Troy, MI 48098
Phone (248) 265-4600

2300 Haggerty Rd
Ste 2100
West Bloomfield, MI 48323
Phone (248) 624-7246

Organizations & group practices 12

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 2

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": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1760628713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6628 COLLEGE PARK",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483461065",
            "telephone_number": "248-563-6323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6628 COLLEGE PARK",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483461065",
            "telephone_number": "248-563-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "TAMARA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-22",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704248191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; 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.