Individual provider Active NPI

Michael Mark Rearick, CRNA

  • Certified Registered Nurse Anesthetist
  • Front Royal, VA
National Provider Identifier
1891740445
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024137990 Issued in VA
Practice address
1000 N Shenandoah Ave
Front Royal, VA 22630-3547
Phone
(540) 636-0296
Fax
(540) 636-0258
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

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 0024137990 VA Primary

Addresses

Primary practice location

1000 N Shenandoah Ave
Front Royal, VA 22630-3547

Mailing address

759 S Main St
Woodstock, VA 22664-1127
Phone (540) 459-1287

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
4463SCMDSpeech-Language Pathologist
0024137990VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Pulaski Community Hospital Inc PastSince Jan 1, 1990 Accepting new patients
Mousam Valley Orthopaedics PA Past Accepting new patients
Pulaski Community Hospital Inc PastSince Jan 1, 1990 Accepting new patients
The Medical Group Department of Goodall Hospital Past Accepting new patients
Norton Community Physician Services LLC Past Accepting new patients
Norton Community Physician Services LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1891740445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 S MAIN ST",
            "city": "WOODSTOCK",
            "state": "VA",
            "postal_code": "226641127",
            "telephone_number": "540-459-1287",
            "fax_number": "540-459-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N SHENANDOAH AVE",
            "city": "FRONT ROYAL",
            "state": "VA",
            "postal_code": "226303547",
            "telephone_number": "540-636-0296",
            "fax_number": "540-636-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARICK",
        "first_name": "MICHAEL",
        "middle_name": "MARK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024137990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Front Royal, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; 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.