MR. KYLE D. JENNINGS (NPI# 1124422217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124422217 |
| Entity Type | Individual |
| Full Name | MR. KYLE D. JENNINGS |
| Credential | CRNA |
| Practice Address |
44201 Dequindre Rd Troy MI 48085-1117 |
| Mailing Address |
750 Stephenson Hwy Troy MI 48083-1103 |
| Practice Telephone | 2482675700 |
| Practice Fax Number | 2482675703 |
| Mailing Telephone | 2485774995 |
| Mailing Fax Number | 2485773526 |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2014-10-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 4704269646 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427684489 | Kyle James Jennings | Nurse Anesthetist, Certified Registered | 715 N Saint Joseph Ave, Hastings, NE 68901-4451 | 2020-03-20 |
| 1336481514 | Kyle D Jennings | Counselor | 702 W Chestnut St, Bloomington, IL 61701-2814 | 2013-03-26 |
| Street Address |
44201 DEQUINDRE RD |
| City | TROY |
| State | MI |
| Zip Code | 48085-1117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801892468 | Mary Margaret Guerra | Nurse Practitioner | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2005-06-28 |
| 1578163523 | Laura Marie Metz | Nurse Practitioner | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-10-29 |
| 1538767983 | Virginia Clare Fielhauer | Physician Assistant | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-10-16 |
| 1437756095 | Amanda Michelle Hirsch | Nurse Practitioner | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-10-07 |
| 1467059113 | Scott Matthew Grumeretz | Physical Therapist | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-10-06 |
| 1285231944 | Brianne Patton | Physical Therapist | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-10-06 |
| 1679180483 | John L Freds | Registered Nurse | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-09-25 |
| 1720694300 | Justine Marie Doss | Nurse Practitioner | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-09-19 |
| 1649885872 | Sara Dawn Thueme | Nurse Practitioner | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-09-14 |
| 1316561772 | Jodi Marini | Registered Nurse | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-06-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790327252 | Long Lake Rx | Pharmacy | 2888 East Long Lake Rd #120, Suite 120, Troy, MI 48085 | 2019-10-16 |
| 1538712948 | Long Lake Rx | Pharmacy | 2888 East Long Lake Rd, Suite 120, Troy, MI 48085 | 2019-07-24 |
| 1669035093 | William Beaumont Hospital | Pharmacy | Beaumont Hospital Troy, 44201 Dequindre, Room 11a0310, Troy, MI 48085 | 2019-04-22 |
| 1487126926 | Long Lake Rx | Pharmacy | 2888 E Long Lake Rd Suite 120, Troy, MI 48085 | 2018-12-21 |
| 1295226579 | Jeffrey Paul Biehl | Nurse Anesthetist, Certified Registered | 44249 Dequindre Rd., Troy, MI 48085 | 2018-05-23 |
| 1619478666 | Trisha Misiewicz | Physical Therapist | 42201 Dequindre Rd, Troy, MI 48085 | 2018-02-26 |
| 1760900393 | Sensory Rehabilitation LLC | Physical Therapist | 4413, Reilly Ct, Troy, MI 48085 | 2017-09-04 |
| 1841710837 | James L Chang | Dentist | 1883 E Wattles, Troy, MI 48085 | 2017-06-21 |
| 1033567953 | Brittany N David | Physician Assistant | 2041 E Square Lake Rd Suite 300, Troy, MI 48085 | 2016-06-01 |
| 1053784199 | Brianna Lynn Manica | Nurse Practitioner | 44201 Dequindre Rd., Ste. 400 Troy Beaumont Hospital, Troy, MI 48085 | 2015-11-12 |
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| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295226579 | Jeffrey Paul Biehl | Nurse Anesthetist, Certified Registered | 44249 Dequindre Rd., Troy, MI 48085 | 2018-05-23 |
| 1356782411 | Michelle Louise Knoblock | Nurse Anesthetist, Certified Registered | 1560 E Maple Rd Ste 100, Troy, MI 48083 | 2013-07-17 |
| 1124340989 | Devone Jabara | Nurse Anesthetist, Certified Registered | 130 Town Center Drive Ste. 203, Payor Contract Services, Troy, MI 48083-1103 | 2010-02-22 |
| 1013249945 | Cmm Tri-county Anesthesia Staffing Services, LLC | Nurse Anesthetist, Certified Registered | 64 Starr Dr, Troy, MI 48083-1646 | 2010-02-03 |
| 1194056093 | Carol Ann Slazinik | Nurse Anesthetist, Certified Registered | 8634 Blackjack Hollow Ln, Troy, IL 62294 | 2010-01-18 |
| 1669588620 | Carol C Richardson | Nurse Anesthetist, Certified Registered | 4550 Investment Dr Ste 100, Troy, MI 48098-6334 | 2006-08-22 |
| 1104861087 | Gregory J Golen | Nurse Anesthetist, Certified Registered | 1301 W Long Lake Rd, Suite 237, Troy, MI 48098-6328 | 2006-06-17 |
| 1437108867 | Sherly C Jacob | Nurse Anesthetist, Certified Registered | 44201 Dequindre Road, Troy, MI 48085-1117 | 2006-05-10 |
| 1285600288 | Jean Bergin | Nurse Anesthetist, Certified Registered | 44201 Dequindre, 400 Fsc - PCs, Troy, MI 48085-1198 | 2006-02-28 |
| 1467451021 | Michael T Phelan | Nurse Anesthetist, Certified Registered | 2215 Burdett Avenue, Samaritan Hospital, Troy, NY 12180 | 2005-07-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.