Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Corey J Landacre, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1760742977

Mr. Corey J Landacre, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Grand Rapids, Michigan. Qualified in 2012, 14 years ago. Practices with Main Street Anesthesia of New Mexico, LLC, a 228-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
14
Licensed in
MI
In the registry since
2012
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9493
Phone: (616) 364-4200
Fax: (616) 364-7347
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 4704266020 (MI)

Record details

NPI number1760742977
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedMay 22, 2012
Last updated in NPPESJuly 3, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Main Street Anesthesia Of New Mexico, Llc — 228 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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