Nicole McColley, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704271330 Issued in MI

Practice address

640 Jackson St
Saint Paul, MN 55101-2502

Phone

(651) 254-3456

NPI assigned

Sep 22, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Group practices

Lakeland Hospitals at Niles and St Joseph IncGroup PAC ID 7517929037, 134 clinicians

Apollo Medical Group of Michigan PLLCGroup PAC ID 6103354329, 24 clinicians

Rest Assured Anesthesia Management IncGroup PAC ID 3274971007, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Apollo Medical Group of Michigan PLLC

  • Anesthesiology Physician
  • Portage, MI
  • NPI 1699582593

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Lakeland Hospitals at Niles and St Joseph, Inc

  • General Acute Care Hospital
  • Saint Joseph, MI
  • NPI 1134220031
  Medicare reassignment Care Compare group NPD
• Rest Assured Anesthesia Management, Inc.

  • Certified Registered Nurse Anesthetist
  • Fremont, IN
  • NPI 1063284891

  MI, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Kalamazoo Anesthesiology P C

  • Anesthesiology Physician
  • Kalamazoo, MI
  • NPI 1407821796
  Medicare reassignment
• Lakeland Hospitals at Niles and St Joseph, Inc

  • Community Health Clinic/Center
  • Saint Joseph, MI
  • NPI 1184513731
  NPD
• Lakeland Hospitals at Niles and St Joseph, Inc

  • Anesthesiology Physician
  • Saint Joseph, MI
  • NPI 1598305641

  Nurse Anesthetist, Certified Registered

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lakeland Hospitals at Niles and St Joseph, Inc

  • General Acute Care Hospital
  • Saint Joseph, MI
  • NPI 1134220031
  Care Compare affiliation

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1790019990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 PEELER ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490082300",
            "telephone_number": "269-345-8618",
            "fax_number": "269-345-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Peeler St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490082300",
            "country_code": "US",
            "telephone_number": "269-345-8618 x1223",
            "fax_number": "269-345-1508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCOLLEY",
        "first_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-22",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704271330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI STATE LICENSE",
            "identifier": "4704271330",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA LICENSE",
            "identifier": "1790",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaci Rae McCleary, MD
• Monica Jean McCleary, CNM
• Eric McClellan
• Felix McClung, LICSW
• Daniel Robert McClure, PSYD, LP
• Keith Bruce McCollister, M.D.
• Kim S McConnell, MD
• William David McConnell, PA-C
• Patti McCool
• Steven E McCormack, MD

• Certified Registered Nurse Anesthetist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Certified Registered Nurse Anesthetist in Minnesota

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