Active NPI
Michael Gremmelsbacher, CRNA
- Certified Registered Nurse Anesthetist
- Belleville, IL
National Provider Identifier
1891908091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 068365
- Practice address
- 28 N 64TH St
Belleville, IL 62223-3808 - Phone
- (314) 991-0985
- Fax
- (908) 653-9305
- NPI assigned
- May 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 068365 | MO | Primary |
Addresses
Primary practice location
28 N 64TH St
Belleville, IL 62223-3808
Mailing address
PO Box 822344
Philadelphia, PA 19182-2344
Phone (314) 991-0985
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 068365 | Other | MO | MEDICAL 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)
- Enrolled
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Broad Midwest Anesthesia, LLC | Past | Accepting new patients | |
| Broad Anesthesia Associates | Past | Accepting new patients | |
| Midwest Anesthesia Inc. | 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.
-
- Anesthesiology Physician
- Boca Raton, FL
- NPI 1033136064
-
- Anesthesiology Physician
- Saint Louis, MO
- NPI 1376705848
-
- Anesthesiology Physician
- Saint Louis, MO
- NPI 1285717587
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891908091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 822344",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191822344",
"telephone_number": "314-991-0985",
"fax_number": "908-653-9305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 N 64TH ST",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622233808",
"telephone_number": "314-991-0985",
"fax_number": "908-653-9305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREMMELSBACHER",
"first_name": "MICHAEL",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "068365",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "068365",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.