Individual provider Active NPI

Blair Scott Dudley, CRNA

  • Certified Registered Nurse Anesthetist
  • Ann Arbor, MI
National Provider Identifier
1902129760
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704250692 Issued in MI
Practice address
1500 E Medical Center Dr
1H247 University Hospital
Ann Arbor, MI 48109-5048
Phone
(734) 936-4280
NPI assigned
Mar 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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 4704250692 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
1H247 University Hospital
Ann Arbor, MI 48109-5048

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Other practice location 1

1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone (231) 672-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100826000894 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153445218 Reassigns benefits to 4 organizations
I20240507004509 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153445218 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians
Kalamazoo Anesthesiology P CGroup PAC ID 3375449473, 135 clinicians

Practice addresses (Care Compare)

1000 Wall St
Ann Arbor, MI 48105-1912
Phone (734) 936-4000

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000

1840 Wealthy St SE
Corewell Health Medical Group West
Grand Rapids, MI 49506-2921
Phone (616) 885-5000

4270 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (734) 936-4000

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

900 Peeler St
Kalamazoo, MI 49008-2300
Phone (269) 345-8618

Hospital & facility affiliations

  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7415NCMDAudiologist-Hearing Aid Fitter
4704250692MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Nurse Anesthetist, Certified Registered CurrentSince Feb 14, 2010 Accepting new patients
Coastal Carolina Sedation Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2025 Accepting new patients
Regents of the University of Michigan CurrentSince Feb 14, 2010 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Apr 27, 2026 Accepting new patients
Kalamazoo Anesthesiology P C CurrentSince Jul 10, 2024 Accepting new patients
Surgery Center Anesthesia Providers PC Nurse Anesthetist, Certified Registered CurrentSince Apr 9, 2024 Accepting new patients

Locations

1500 E Medical Center Dr
#1H247
Ann Arbor, MI 48109
Phone (734) 936-4280

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

4270 Plymouth Rd
Ann Arbor, MI 48109
Phone (734) 232-3000

3621 S State St
#700
Ann Arbor, MI 48108

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

900 Peeler St
Kalamazoo, MI 49008
Phone (269) 345-8618

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

400 10th St E
Waconia, MN 55387

320 Lillington Ave
Ste 101
Charlotte, NC 28204
Phone (704) 332-1574

1919 S 16th St
Wilmington, NC 28401
Phone (910) 763-9334

5115 Oleander Dr
Wilmington, NC 28403
Phone (910) 362-1011

Interoperability endpoints

  • Direct secure messaging: bdudley2863602@direct.trinity-health.org

Organizations & group practices 8

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1902129760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "address_2": "1H247 UNIVERSITY HOSPITAL",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095048",
            "telephone_number": "734-936-4280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Sherman Blvd",
            "address_purpose": "LOCATION",
            "city": "Muskegon",
            "state": "MI",
            "postal_code": "494441849",
            "country_code": "US",
            "telephone_number": "231-672-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "BLAIR",
        "middle_name": "SCOTT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-09",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704250692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.