Active NPI
Jayson Mark Michnowicz, CRNA
- Certified Registered Nurse Anesthetist
- Durham, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 264937
- Practice address
- 1116 Valley Rose Way
Durham, NC 27712-2994 - Phone
- (618) 420-5903
- NPI assigned
- Aug 1, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Certified Registered Nurse Anesthetist | 367500000X | 264937 | NC | Primary |
Addresses
Primary practice location
1116 Valley Rose Way
Durham, NC 27712-2994
Mailing address
1116 Valley Rose Way
Durham, NC 27712-2994
Phone (618) 420-5903
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 264937 | NC | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Anesthesiology of North Carolina, PLLC | Anesthesiology | Current | Accepting new patients |
| Duke Health Integrated Practice, Inc. | Current | Accepting new patients | |
| American Anesthesiology of North Carolina, PLLC | Anesthesiology | Current | Accepting new patients |
Locations
40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588
2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289
3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705
4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034
Organizations & group practices 3
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.
-
- Certified Registered Nurse Anesthetist
- Burlington, NC
- NPI 1053677195
Anesthesiology
-
- General Practice Physician
- Durham, NC
- NPI 1205553369
-
- Pain Medicine (Anesthesiology) Physician
- Wake Forest, NC
- NPI 1942248547
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668988800000",
"number": "1811329816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1116 VALLEY ROSE WAY",
"city": "DURHAM",
"state": "NC",
"postal_code": "277122994",
"telephone_number": "618-420-5903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1116 VALLEY ROSE WAY",
"city": "DURHAM",
"state": "NC",
"postal_code": "277122994",
"telephone_number": "618-420-5903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHNOWICZ",
"first_name": "JAYSON",
"middle_name": "MARK",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-01",
"last_updated": "2022-11-21",
"certification_date": "2022-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NC",
"license": "264937",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.