Individual provider Active NPI

Jesse Stokke, APRN, CRNA

  • Certified Registered Nurse Anesthetist
  • Duluth, MN
National Provider Identifier
1043635360
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA0748 Issued in MN
Practice address
915 E 1St St
Duluth, MN 55805
Phone
(218) 249-5352
Fax
(218) 249-5534
NPI assigned
Feb 24, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R187104-7 MN
Certified Registered Nurse Anesthetist 367500000X CRNA0748 MN Primary

Addresses

Primary practice location

915 E 1St St
Duluth, MN 55805

Mailing address

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5352

Other practice location 1

400 E 3rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140502000552 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062645708 Reassigns benefits to 3 organizations
I20200609002002 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062645708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Anesthesia PAGroup PAC ID 9032016936, 14 clinicians

Practice addresses (Care Compare)

1420 London Rd
Suite 100
Duluth, MN 55805-2437
Phone (218) 728-0650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
CRNA0748MNMDCertified Registered Nurse Anesthetist
R187104-7MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Hospital of Duluth CurrentSince May 7, 2018 Accepting new patients
St. Luke'S Hospital of Duluth Current Accepting new patients
St. Luke'S Hospital of Duluth Nurse Anesthetist, Certified Registered CurrentSince May 18, 2020 Accepting new patients
North Shore Anesthesia P.a Nurse Anesthetist, Certified Registered CurrentSince Mar 29, 2021 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince May 7, 2018 Accepting new patients
Northland Anesthesia Associates Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2019 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

10 5th St SE
Cook, MN 55723
Phone (218) 626-3441

1420 London Rd
Ste 100
Duluth, MN 55805
Phone (218) 728-0650

4316 Rice Lake Rd
Ste 104
Duluth, MN 55811
Phone (218) 514-0514

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

400 10th St E
Waconia, MN 55387

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

Organizations & group practices 6

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": "1393200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1043635360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052107",
            "telephone_number": "218-249-5352",
            "fax_number": "218-249-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-249-5352",
            "fax_number": "218-249-5534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558051951",
            "country_code": "US",
            "telephone_number": "218-786-8364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOKKE",
        "first_name": "JESSE",
        "credential": "APRN, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-24",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R187104-7",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "CRNA0748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "915 E 1st St",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.