Individual provider Active NPI

Tracy Lynn Tomlinson-Bathgate, CRNA

  • Certified Registered Nurse Anesthetist
  • Wayne, MI
National Provider Identifier
1881866028
Registry record updated Nov 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704172342 Issued in MI
Practice address
33155 Annapolis St
Wayne, MI 48184-2405
Phone
(734) 467-4667
Fax
(734) 467-2303
NPI assigned
Mar 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 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 4704172342 MI Primary

Addresses

Primary practice location

33155 Annapolis St
Wayne, MI 48184-2405

Mailing address

33155 Annapolis St
Wayne, MI 48184-2405
Phone (734) 467-4667

Other names 1

  • Tracy Lynn Carlisle Former name

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)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704172342MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan II PC Nurse Anesthetist, Certified Registered CurrentSince Mar 25, 2009 Accepting new patients

Locations

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

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

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

Organizations & group practices 1

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": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385424000000",
    "number": "1881866028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33155 ANNAPOLIS ST",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481842405",
            "telephone_number": "734-467-4667",
            "fax_number": "734-467-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33155 ANNAPOLIS ST",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481842405",
            "telephone_number": "734-467-4667",
            "fax_number": "734-467-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMLINSON-BATHGATE",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-27",
        "last_updated": "2013-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704172342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "CARLISLE",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wayne, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; 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.