BEAUMONT WEST BLOOMFIELD ASC LLC
NPI 1275790206
Nurse Anesthetist, Certified Registered in W Bloomfield, MI

NPI Status: Active since May 19, 2008

Contact Information

6900 ORCHARD LAKE RD
LL100
W BLOOMFIELD, MI
ZIP 48322
Phone: (248) 406-2400
Fax: (248) 406-2401

NPI Profile Information
Primary Taxonomy
Group Taxonomy
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Nurse Anesthetist, Certified Registered
CLIA Number: 23D2058940
CLIA Cert. Type: Ambulatory Surgery Center
CLIA Exp. Date: 08-12-2026

About BEAUMONT WEST BLOOMFIELD ASC LLC

This page provides the complete NPI Profile along with additional information for Beaumont West Bloomfield Asc Llc, a provider established in W Bloomfield, Michigan operating as a Nurse Anesthetist, Certified Registered. The healthcare provider is registered in the NPI registry with number 1275790206 assigned on May 2008. The practitioner's primary taxonomy code is 367500000X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Karen Connolly Rn (Project Coordinator)

NPI: 1275790206
Provider Name: BEAUMONT WEST BLOOMFIELD ASC LLC
Entity Type: Organization
Location Address: 6900 ORCHARD LAKE RD LL100 W BLOOMFIELD, MI 48322
Location Phone: (248) 406-2400
Location Fax: (248) 406-2401
Mailing Address: 6900 ORCHARD LAKE RD LL100 W BLOOMFIELD, MI 48322
Mailing Phone: (248) 406-2400
Mailing Fax: (248) 406-2401
Is Sole Proprietor?: No
Is Organization Subpart?: Yes
Enumeration Date: 05-19-2008
Last Update Date: 05-19-2008
Code Navigator

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Nurse Anesthetist, Certified Registered
Taxonomy Code: 367500000X
Type: Physician Assistants & Advanced Practice Nursing Providers
License State: MI
Taxonomy Description: (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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: KAREN CONNOLLY RN
Authorized Official Title: PROJECT COORDINATOR
Authorized Official Phone: (248) 798-3200

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 23D2058940
Facility Type: Ambulatory Surgery Center
Certificate Effective Date: August 13, 2024
Certificate Expiration Date: August 12, 2026
Laboratory Director: DR. KURT D. BERNACKI
Certificate Type: Certificate of Accreditation
Certificate Type Description: This is a CLIA certificate is issued to Beaumont West Bloomfield Asc Llc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1275790206, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 14 → 1 + 4

Pos 4

Unchanged

Pos 5

Doubled → 14 → 1 + 4

Pos 6

Unchanged

Pos 7

Doubled → 0

Pos 8

Unchanged

Pos 9

Doubled → 0

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 7 → 14 → 5 0 → 0 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 4 + 5 + 1 + 4 + 9 + 0 + 2 + 0 + 24 = 54

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6

This NPI is valid

The calculated check digit is 6, which matches the last digit of 1275790206.