Individual provider Active NPI

Virginia Hagood, CRNA

  • Certified Registered Nurse Anesthetist
  • Royal Oak, MI
National Provider Identifier
1790751683
Registry record updated Aug 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704134430 Issued in MI
Practice address
3601 W. 13 Mile Rd
400 FSC-PCS
Royal Oak, MI 48073-6769
Phone
(248) 423-2481
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2017

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 4704134430 MI Primary

Addresses

Primary practice location

3601 W. 13 Mile Rd
400 FSC-PCS
Royal Oak, MI 48073-6769

Mailing address

130 Town Center Drive
Suite 203
Troy, MI 48084-1744
Phone (248) 585-8221

Other identifiers 2

IdentifierTypeStateIssuer
4167587MedicaidMI
430F364420OtherMIBCBSM

Other names 1

  • Virginia Miller Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090921000164 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800942608 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704134430MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
William Beaumont Hospital Nurse Anesthetist, Certified Registered CurrentSince Sep 20, 1999 Accepting new patients
William Beaumont Hospital CurrentSince Sep 20, 1999 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients
Beaumont West Bloomfield ASC LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Beaumont West Bloomfield ASC LLC Past Accepting new patients

Locations

3601 W 13 Mile Rd
Royal Oak, MI 48073

3601 W 13 Mile Rd
#400
Royal Oak, MI 48073
Phone (248) 423-2481

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

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

Organizations & group practices 5

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502150400000",
    "number": "1790751683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 TOWN CENTER DRIVE",
            "address_2": "SUITE 203",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480841744",
            "telephone_number": "248-585-8221",
            "fax_number": "248-585-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W. 13 MILE RD",
            "address_2": "400 FSC-PCS",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736769",
            "telephone_number": "248-423-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGOOD",
        "first_name": "VIRGINIA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2017-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704134430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4167587",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "430F364420",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIRGINIA",
            "last_name": "MILLER",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Aug 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.