Individual provider Active NPI

Mary B. Brennan, CRNA

  • Certified Registered Nurse Anesthetist
  • Ypsilanti, MI
National Provider Identifier
1922062009
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704115695 Issued in MI
Practice address
5301 E Huron River Dr
Ypsilanti, MI 48197-1051
Phone
(734) 712-3840
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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 4704115695 MI Primary

Addresses

Primary practice location

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

Mailing address

19329 Upland CT
Northville, MI 48167-1912
Phone (248) 348-3207

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

State licenses

LicenseStateTypeSpecialty
4704115695MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sjmhs Anesthesia Services Nurse Anesthetist, Certified Registered Current Accepting new patients
Saint Joseph Mercy Saline Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Saint Joseph Mercy Livingston Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Associates of Ann Arbor, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

Organizations & group practices 4

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190937600000",
    "number": "1922062009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19329 UPLAND CT",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671912",
            "telephone_number": "248-348-3207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E HURON RIVER DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "MARY",
        "middle_name": "B.",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2007-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704115695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.

Verify at the official NPI Registry.