Individual provider Active NPI

Sally Range, CRNA

  • Certified Registered Nurse Anesthetist
  • Livonia, MI
National Provider Identifier
1861420937
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704155743 Issued in MI
Practice address
36475 5 Mile Rd
Livonia, MI 48154-1971
Phone
(734) 655-2022
NPI assigned
Jun 29, 2006
Last updated
Sep 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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 4704155743 MI Primary

Addresses

Primary practice location

36475 5 Mile Rd
Livonia, MI 48154-1971

Mailing address

47953 Park Lane CT
Canton, MI 48187-5469

Other identifiers 1

IdentifierTypeStateIssuer
104199983MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080815000471 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012082605 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Michigan II PCGroup PAC ID 7911895164, 22 clinicians
Monaco Management LLCGroup PAC ID 9739577461, 37 clinicians

Practice addresses (Care Compare)

3400 E Jolly Rd
Lansing, MI 48910-8542
Phone (517) 272-1063

4851 E Pickard St
Mt. Pleasant Surgery Center
Mount Pleasant, MI 48859-2078
Phone (213) 499-1159

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704155743MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Carson Hospital CurrentSince Jun 7, 2014 Accepting new patients
Sparrow Carson Hospital Current Accepting new patients
Sparrow Carson Hospital Nurse Anesthetist, Certified Registered CurrentSince Jun 7, 2014 Accepting new patients
Northstar Anesthesia of Michigan II PC Nurse Anesthetist, Certified Registered CurrentSince Aug 27, 2018 Accepting new patients
Monaco Management, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 2, 2026 Accepting new patients
Sparrow Carson Hospital Current Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

300 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0104

406 E Elm St
Carson City, MI 48811
Phone (517) 584-3131

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

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

4851 E Pickard St
Mt Pleasant, MI 48858
Phone (989) 772-3009

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

Organizations & group practices 6

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1861420937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47953 PARK LANE CT",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481875469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36475 5 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541971",
            "telephone_number": "734-655-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANGE",
        "first_name": "SALLY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704155743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104199983",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.