Individual provider Active NPI

Amanda M. Vannatter, CRNA

  • Certified Registered Nurse Anesthetist
  • Royal Oak, MI
National Provider Identifier
1770854044
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704259709 Issued in MI
Practice address
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone
(248) 898-7784
NPI assigned
Jan 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 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 4704259709 MI Primary

Addresses

Primary practice location

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Mailing address

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-7784

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120302000487 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163681644 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians

Practice addresses (Care Compare)

33155 Annapolis St
Wayne, MI 48184-2405
Phone (214) 687-0001

468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Phone (214) 687-0001

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eastside Group LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 9, 2019 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients
William Beaumont Hospital Nurse Anesthetist, Certified Registered CurrentSince Jan 12, 2012 Accepting new patients
Environ Anesthesia, LLC. Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2020 Accepting new patients
William Beaumont Hospital CurrentSince Jan 12, 2012 Accepting new patients
West Michigan Aas LLC CurrentSince Oct 13, 2024 Accepting new patients

Locations

949 National Ave
Ste 151
Lexington, KY 40502
Phone (859) 509-8399

4024 Park East Ct SE
Grand Rapids, MI 49546
Phone (231) 592-3102

3800 Centennial Dr
Grass Lake, MI 49240
Phone (517) 701-3100

468 Cadieux Rd
Grosse Pt Wds, MI 48230
Phone (313) 343-1000

17700 23 Mile Rd
Ste 250
Macomb, MI 48044
Phone (586) 416-7500

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

25500 Meadowbrook Rd
Ste 110
Novi, MI 48375
Phone (248) 477-0220

3601 W 13 Mile Rd
Royal Oak, MI 48073

326 N Main St
Royal Oak, MI 48067
Phone (248) 584-7600

5400 Mackinaw Rd
Ste 6100
Saginaw, MI 48604
Phone (989) 792-3100

28963 Little Mack Ave
Ste 10
St Clr Shores, MI 48081
Phone (586) 447-5110

28963 Little Mack Ave
Ste 103
St Clr Shores, MI 48081
Phone (586) 447-5110

1560 E Maple Rd
#100
Troy, MI 48083
Phone (248) 817-2001

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

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 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": "1326931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1770854044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-7784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNATTER",
        "first_name": "AMANDA",
        "middle_name": "M.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-19",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704259709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.