Individual provider Active NPI

Theresa M Delpup-Smith

  • Certified Registered Nurse Anesthetist
  • Troy, MI
National Provider Identifier
1851407977
Registry record updated Aug 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
TD149085 Issued in MI
Practice address
4550 Investment Dr Ste 100
Troy, MI 48098-6334
Phone
(248) 265-4600
NPI assigned
Aug 22, 2006
Last updated
Aug 7, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2013

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 TD149085 MI Primary

Addresses

Primary practice location

4550 Investment Dr Ste 100
Troy, MI 48098-6334

Mailing address

744 W Michigan Ave
Jackson, MI 49201-1909
Phone (517) 787-6440

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040901000344 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7517932619 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Essential Anesthesia Services, PLCGroup PAC ID 0244492494, 17 clinicians

Practice addresses (Care Compare)

264 W Maple Rd
Suite 100
Troy, MI 48084-5458
Phone (248) 269-5594

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TD149085MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan II PC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2016 Accepting new patients
Surgical Centers of Michigan, LLC CurrentSince Mar 1, 2016 Accepting new patients
Gastrointestinal Specialists PC CurrentSince Aug 20, 2013 Accepting new patients
Macomb Endoscopy Center PLC Current Accepting new patients
Macomb Endoscopy Center, PLC CurrentSince Mar 1, 2016 Accepting new patients
Superior Anesthetists Associates, Inc. CurrentSince Mar 14, 2016 Accepting new patients
Essential Anesthesia Services, PLC Nurse Anesthetist, Certified Registered CurrentSince Aug 20, 2013 Accepting new patients
Surgical Centers of Michigan, LLC. Current Accepting new patients
St. Joseph Mercy Hospital Crna Group Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

744 W Michigan Ave
Jackson, MI 49201
Phone (517) 205-2146

1707 Lake Lansing Rd
Lansing, MI 48912
Phone (517) 267-0033

3400 E Jolly Rd
Lansing, MI 48910
Phone (517) 272-1063

48801 Romeo Plank Rd
Ste 101
Macomb, MI 48044
Phone (586) 726-8423

26750 Providence Pkwy
Ste 100
Novi, MI 48374
Phone (248) 662-1500

1560 E Maple Rd
#100
Troy, MI 48083
Phone (248) 817-2001

264 W Maple Rd
Ste 100
Troy, MI 48084
Phone (248) 269-5594

264 W Maple Rd
Ste 200
Troy, MI 48084
Phone (248) 273-9930

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

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

4600 Investment Dr
Ste 270
Troy, MI 48098
Phone (248) 267-6222

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1851407977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011909",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 INVESTMENT DR STE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480986334",
            "telephone_number": "248-265-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELPUP-SMITH",
        "first_name": "THERESA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "TD149085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; 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.