Individual provider Active NPI

Amy J. Kortman, CRNA

  • Certified Registered Nurse Anesthetist
  • Byron Center, MI
National Provider Identifier
1841376605
Registry record updated Nov 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704200922 Issued in MI
Practice address
159 Penny LN SE
Byron Center, MI 49315-9799
Phone
(616) 827-0144
Fax
(616) 827-0144
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2008

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 4704200922 MI Primary

Addresses

Primary practice location

159 Penny LN SE
Byron Center, MI 49315-9799

Mailing address

159 Penny LN SE
Byron Center, MI 49315-9799
Phone (616) 827-0144

Other identifiers 2

IdentifierTypeStateIssuer
4936735MedicaidMI
4704200922OtherMICRNA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704200922MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Louisburg Hma Physician Management, LLC Past Accepting new patients
Kalamazoo Anesthesiology P C Past Accepting new patients
Anesthesiology Medical Consultants, PLLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227225600000",
    "number": "1841376605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 PENNY LN SE",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493159799",
            "telephone_number": "616-827-0144",
            "fax_number": "616-827-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 PENNY LN SE",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493159799",
            "telephone_number": "616-827-0144",
            "fax_number": "616-827-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORTMAN",
        "first_name": "AMY",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2008-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704200922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4936735",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA LICENSE",
            "identifier": "4704200922",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Byron Center, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.