Sandra Sloane Blix, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Niles, MI
NPI 1982679080 · NPPES record last updated Dec 10, 2019
Key facts
- NPI
- 1982679080
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 4704176326 (MI)
- Practice address
- 31 N Saint Joseph Ave
Niles, MI 49120-2207 - Phone
- (269) 687-1879
- Fax
- (269) 683-0104
- NPI assigned
- Feb 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lakeshore Anesthesia Staffing LLC
Practice addresses (Care Compare)
2848 Niles Rd
Suite B
Saint Joseph, MI 49085-3352
Phone (269) 428-3300
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050512000116 | MI | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 2860457595 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704176326 | MI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeland Hospitals at Niles and St Joseph, Inc | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Sparrow Eaton Hospital | Current |
Accepting new patients | |
| Anesthesia Professional Services PC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Pathology Assoc of Southwestern Michigan, PC | Current | Accepting new patients | |
| Lakeland Hospitals at Niles and St Joseph, Inc | Current | Accepting new patients | |
| Lakeshore Anesthesia Staffing LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Sparrow Eaton Hospital | Current |
Accepting new patients | |
| Lakeland Hospitals at Niles and St Joseph, Inc | Current |
Accepting new patients | |
| Sparrow Eaton Hospital | Current | Accepting new patients | |
| Kalamazoo Anesthesiology P C | Past | Accepting new patients |
Locations
8175 Reliable Pkwy
Chicago, IL 60686
321 E Harris St
Charlotte, MI 48813
Phone (517) 541-5840
750 E Beltline Ave NE
Ste 203
Grand Rapids, MI 49525
Phone (616) 940-3600
5623 E Dunbar Rd
Monroe, MI 48161
31 N Saint Joseph Ave
Niles, MI 49120
Phone (269) 428-2417
2848 Niles Rd
Ste B
Saint Joseph, MI 49085
Phone (269) 428-3300
1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 4704176326 | MI | Yes |
Addresses
Primary practice location
31 N Saint Joseph Ave
Niles, MI 49120-2207
Mailing address
31 N Saint Joseph Ave
Niles, MI 49120-2207
Phone (269) 687-1879
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4299414 | Medicaid | MI |
Other providers in Niles, MI
- Berrien Mental Health Authority
- Better Together Birth Services
- Sarah Elizabeth Biddle
- Renee Denise Binns
- Blessed Home Afc Services, LLC
- Danisha Blythe
- Alexis Bock
- Andrea J Bontrager
- Mendy Boocher
- Sharon Diane Bouhaja
All providers in Niles, MI · Certified Registered Nurse Anesthetist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.