Active NPI
David L. Mutschelknaus, CRNA
- Certified Registered Nurse Anesthetist
- Sioux Falls, SD
National Provider Identifier
1104849363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- CR000171
- Practice address
- 1100 E 26TH St
Sioux Falls, SD 57105-4023 - Phone
- (605) 338-7098
- Fax
- (605) 335-3505
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | CR000171 | SD | Primary |
Addresses
Primary practice location
1100 E 26TH St
Sioux Falls, SD 57105-4023
Mailing address
48350 265TH St
Brandon, SD 57005-7206
Phone (605) 582-2374
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4996317 | Other | SD | BLUE CROSS SD |
| 1551382 | Medicaid | IA | |
| 320S0MU | Other | MN | BLUE CROSS MN |
| 5752604 | Medicaid | SD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0171 | SD | MD | Physician Assistant |
| CR000171 | SD | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesiology Associates | Past | Accepting new patients |
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.
-
- Specialist
- Sioux Falls, SD
- NPI 1902249816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207267200000",
"number": "1104849363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48350 265TH ST",
"city": "BRANDON",
"state": "SD",
"postal_code": "570057206",
"telephone_number": "605-582-2374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 E 26TH ST",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571054023",
"telephone_number": "605-338-7098",
"fax_number": "605-335-3505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUTSCHELKNAUS",
"first_name": "DAVID",
"middle_name": "L.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2008-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "SD",
"license": "CR000171",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS SD",
"identifier": "4996317",
"state": "SD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1551382",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS MN",
"identifier": "320S0MU",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5752604",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.