Individual provider Active NPI

Kerri Ann Christofferson, CRNA

  • Certified Registered Nurse Anesthetist
  • Royal Oak, MI
National Provider Identifier
1780916395
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704244075 Issued in MI
Practice address
3601 W 13 Mile Rd
Beaumont Hospital Royal Oak
Royal Oak, MI 48073-6712
Phone
(248) 898-7784
Fax
(248) 898-7784
NPI assigned
Feb 6, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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 4704244075 MI Primary

Addresses

Primary practice location

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

Mailing address

130 Town Center Dr Ste 203
Beaumont Medical Staff Affairs
Troy, MI 48084-1744
Phone (248) 585-8216

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120130000381 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880728518 Reassigns benefits to 6 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
Axon Anesthesia Consultants PLCGroup PAC ID 7012276819, 11 clinicians
Long Lake Anesthesiology Consultants PLCGroup PAC ID 7113818980, 94 clinicians

Practice addresses (Care Compare)

1375 S Lapeer Rd
Michigan Institute F
Lake Orion, MI 48360-1421
Phone (248) 693-7950

4550 Investment Dr
Troy, MI 48098-6334
Phone (248) 265-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Asa Staffing Inc Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2026 Accepting new patients
Superior Anesthetists Associates, Inc. CurrentSince Jan 11, 2023 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 Dec 24, 2011 Accepting new patients
Axon Anesthesia Consultants, PLC CurrentSince Jun 17, 2023 Accepting new patients
William Beaumont Hospital CurrentSince Dec 24, 2011 Accepting new patients
Long Lake Anesthesiology Consultants, PLC CurrentSince Aug 1, 2024 Accepting new patients
Endeavor Health Medical Group Past Accepting new patients
Endeavor Health Medical Group Past Accepting new patients

Locations

2009 Momentum Pl
Chicago, IL 60689

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

1375 S Lapeer Rd
Ste 109
Lake Orion, MI 48360
Phone (248) 693-7950

1375 S Lapeer Rd
#F
Lake Orion, MI 48360

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

3601 W 13 Mile Rd
Royal Oak, MI 48073

130 Town Center Dr
Ste 203
Troy, MI 48084
Phone (248) 585-8250

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

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

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

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1265414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469577600000",
    "number": "1780916395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 TOWN CENTER DR STE 203",
            "address_2": "BEAUMONT MEDICAL STAFF AFFAIRS",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480841744",
            "telephone_number": "248-585-8216",
            "fax_number": "248-585-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "address_2": "BEAUMONT HOSPITAL ROYAL OAK",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-7784",
            "fax_number": "248-898-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOFFERSON",
        "first_name": "KERRI",
        "middle_name": "ANN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-06",
        "last_updated": "2016-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704244075",
            "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 Jul 27, 2016; 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.