Active NPI
Keith A Wanner, CRNA
- Certified Registered Nurse Anesthetist
- Watertown, SD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- CR000711
- Practice address
- 401 9TH Ave NW
Watertown, SD 57201-1548 - Phone
- (605) 882-7000
- Fax
- (605) 882-7819
- NPI assigned
- Oct 8, 2008
- 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 | CR000711 | SD | Primary |
Addresses
Primary practice location
401 9TH Ave NW
Watertown, SD 57201-1548
Mailing address
401 9TH Ave NW
Watertown, SD 57201-1548
Phone (605) 882-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CR000711 | Other | SD | CRNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
401 9TH Ave NW
Watertown, SD 57201-1548
Phone (605) 882-7000
Hospital & facility affiliations
- Prairie Lakes Healthcare System, Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.59 of 100
- Quality
- 100
- Promoting interoperability
- 96
- Improvement activities
- 40
- Cost
- 85.3
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prairie Lakes Health Care System Inc | Current | Accepting new patients | |
| Prairie Lakes Health Care System Inc | Current | Accepting new patients | |
| Ikare Anesthesia LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
824 N 11th St
Montevideo, MN 56265
Phone (320) 269-8877
310 8th Ave NW
Ste 508
Aberdeen, SD 57401
905 N 3rd St
Aberdeen, SD 57401
Phone (605) 226-2108
401 9th Ave NW
Watertown, SD 57201
Phone (605) 886-9317
1201 Mickelson Dr
Watertown, SD 57201
Phone (605) 882-0432
Organizations & group practices 3
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.
-
- Rural Acute Care Hospital
- Watertown, SD
- NPI 1720166002
-
- Certified Registered Nurse Anesthetist
- Aberdeen, SD
- NPI 1396594198
Nurse Anesthetist, Certified Registered
-
- Family Medicine Physician
- Castlewood, SD
- NPI 1578369070
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223424000000",
"number": "1114178159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 9TH AVE NW",
"city": "WATERTOWN",
"state": "SD",
"postal_code": "572011548",
"telephone_number": "605-882-7000",
"fax_number": "605-882-7819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 9TH AVE NW",
"city": "WATERTOWN",
"state": "SD",
"postal_code": "572011548",
"telephone_number": "605-882-7000",
"fax_number": "605-882-7819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANNER",
"first_name": "KEITH",
"middle_name": "A",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-08",
"last_updated": "2008-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "SD",
"license": "CR000711",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRNA",
"identifier": "CR000711",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Watertown, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.