Individual provider Active NPI

Kerri Lynn Engelbart, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Collins, CO
National Provider Identifier
1083939748
Registry record updated Dec 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRA-25034 Issued in CO
Practice address
1236 E Elizabeth St
Suite 1
Fort Collins, CO 80524-4000
Phone
(970) 224-2985
NPI assigned
Apr 6, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2013

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 196027 CO
Certified Registered Nurse Anesthetist 367500000X CRA-25034 CO Primary

Addresses

Primary practice location

1236 E Elizabeth St
Suite 1
Fort Collins, CO 80524-4000

Mailing address

1236 E Elizabeth St
Suite 1
Fort Collins, CO 80524-4000
Phone (970) 224-2985

Other identifiers 2

IdentifierTypeStateIssuer
P00860356OtherCORR MEDICARE
30029350MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100802000280 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739212408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Colorado Anesthesia Professionals PLLCGroup PAC ID 6800878760, 155 clinicians

Practice addresses (Care Compare)

2127 E Harmony Rd
200 Ncap PLLC
Fort Collins, CO 80528-3407
Phone (970) 297-6300

Hospital & facility affiliations

  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
196027COMDCertified Registered Nurse Anesthetist
CRA-25034COMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Colorado Anesthesia Professionals PLLC CurrentSince Aug 2, 2010 Accepting new patients

Locations

2127 E Harmony Rd
Ste 200
Fort Collins, CO 80528
Phone (970) 297-6300

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

3702 Automation Way
Fort Collins, CO 80525
Phone (352) 895-2266

2500 E Prospect Rd
Fort Collins, CO 80525
Phone (800) 722-7441

1236 E Elizabeth St
Ste 1
Fort Collins, CO 80524
Phone (970) 484-6256

3702 Automation Way
Ste 103
Fort Collins, CO 80525
Phone (970) 922-3622

2500 Rocky Mountain Ave
Loveland, CO 80538
Phone (970) 297-6425

Organizations & group practices 1

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387152000000",
    "number": "1083939748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 E ELIZABETH ST",
            "address_2": "SUITE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244000",
            "telephone_number": "970-224-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 E ELIZABETH ST",
            "address_2": "SUITE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244000",
            "telephone_number": "970-224-2985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELBART",
        "first_name": "KERRI",
        "middle_name": "LYNN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-06",
        "last_updated": "2013-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "196027",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "CRA-25034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00860356",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30029350",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; 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.