Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

JOHN PEMBERTON CRNA
NPI 1093406514
Nurse Anesthetist, Certified Registered in West Bloomfield, MI

Active since May 16, 2023
6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322(586) 286-0050 Get Directions Write a Review

NPPES record last updated: July 16, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 16, 2026, Aug 24, 2023, May 16, 2023 (3 updates tracked since 2023).

About John Pemberton Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN PEMBERTON CRNA (NPI 1093406514) is an individual nurse anesthetist, certified registered in West Bloomfield, Michigan, licensed in Michigan (4704327563) and active in the NPI registry since May 2023. He is affiliated with Beaumont Hospital - Farmington Hills, maintains a secondary practice location in Oak Park, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1093406514
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameJOHN PEMBERTONCredential: CRNA
Location Address6777 W MAPLE RDWest Bloomfield, MI 48322-3013
Mailing Address1 Ford Pl Ste 3aDetroit, MI 48202-3450 · (313) 874-4806
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateMay 16, 2023
Last NPPES UpdateJuly 16, 20263 updates tracked since enumeration
NPPES CertifiedJuly 16, 2026
NPI 1093406514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License Licensed in MI · 4704327563
Definition

(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.

Also ListedRegistered NurseTaxonomy 163W00000X · License 4704327563 (MI)
6777 W MAPLE RD, West Bloomfield, MI 48322

Secondary Practice Location 1

Location 123491 Norwood StOak Park, MI 48237-2203 · Phone (248) 495-9694

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

John Pemberton Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8325492663
PECOS Enrollment IDI20230920003715

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Beaumont Hospital - Farmington Hills

Acute Care Hospitals · Farmington Hills, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230151
Location28050 Grand River AvenueFarmington Hills, MI 48336 · Oakland County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (Clinical)
6777 W MAPLE RD
WEST BLOOMFIELD, MI 48322
Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)
6777 W MAPLE RD
WEST BLOOMFIELD, MI 48322
Advanced Practice Midwife
6777 W MAPLE RD
WEST BLOOMFIELD, MI 48322
Social Worker (Clinical)
6777 W MAPLE RD
W BLOOMFIELD, MI 48322
General Acute Care Hospital
6777 W MAPLE RD, HENRY FORD HEALTH SYSTEM CARDIOLOGY
WEST BLOOMFIELD, MI 48322
Social Worker
6777 W MAPLE RD
W BLOOMFIELD, MI 48322
Pharmacy Technician
6777 W MAPLE RD
WEST BLOOMFIELD, MI 48322
Pharmacist
6777 W MAPLE RD
WEST BLOOMFIELD, MI 48322

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Pemberton's NPI number?

The NPI number for John Pemberton is 1093406514. It was assigned to this individual provider in the NPPES registry on May 16, 2023.

Where is John Pemberton located?

John Pemberton practices at 6777 W Maple Rd, West Bloomfield, MI 48322. The listed phone number is (586) 286-0050.

What is John Pemberton's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is John Pemberton enrolled in Medicare?

Yes. John Pemberton is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is John Pemberton affiliated with any hospitals?

According to CMS data, John Pemberton is affiliated with Beaumont Hospital - Farmington Hills.

When was this NPI record last updated?

The NPPES record for John Pemberton was last updated on July 16, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.