Individual provider Active NPI

Cari Jo Middelkamp IV

  • Certified Registered Nurse Anesthetist
  • Mankato, MN
National Provider Identifier
1023039617
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R155018-0 Issued in MN
Practice address
1025 Marsh St
Mankato, MN 56001-4752
Phone
(507) 345-2603
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R155018-0 MN Primary

Addresses

Primary practice location

1025 Marsh St
Mankato, MN 56001-4752

Mailing address

1307 Noretta Dr
North Mankato, MN 56003-3422
Phone (507) 385-8143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101213001198 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789871997 Reassigns benefits to 1 organization
I20240322003607 NE Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789871997 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R155018-0MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Medical Imaging, LLC CurrentSince Apr 7, 2024 Accepting new patients
Unmc Physicians CurrentSince Mar 4, 2024 Accepting new patients
Mankato Surgical Center, L.L.C. Nurse Anesthetist, Certified Registered CurrentSince Nov 5, 2025 Accepting new patients
North Platte Surgery Center LLC Current Accepting new patients
North Platte Surgery Center Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 3, 2024 Accepting new patients

Locations

1411 Premier Dr
Mankato, MN 56001
Phone (507) 388-6000

7601 Pioneers Blvd
Lincoln, NE 68506
Phone (402) 484-4475

7555 Pioneers Blvd
Lincoln, NE 68506
Phone (402) 261-1085

621 W Francis St
North Platte, NE 69101
Phone (308) 534-8800

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-5600

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1023039617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 NORETTA DR",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560033422",
            "telephone_number": "507-385-8143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-345-2603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDELKAMP",
        "first_name": "CARI",
        "middle_name": "JO",
        "name_suffix": "IV",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R155018-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.