M. Reuben Richardson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R093267-3 Issued in MN

Practice address

1 Veterans Dr
Anesthesia Department 112a
Minneapolis, MN 55417-2309

Phone

(612) 467-4698

Fax

(612) 727-5961

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mark Reuben Richardson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144237561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 13TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172511",
            "telephone_number": "612-825-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VETERANS DR",
            "address_2": "ANESTHESIA DEPARTMENT 112A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172309",
            "telephone_number": "612-467-4698",
            "fax_number": "612-727-5961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "M. REUBEN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R093267-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "RICHARDSON",
            "middle_name": "REUBEN",
            "credential": "CRNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Chad Richardson, MD
• Conor Alexander Richardson, MD
• Dawhon R Richardson
• Jenna Richardson
• Jerrion Andrew Richardson, MSSW, LICSW
• Melissa Richardson, PA-C
• Portia Richardson, L.AC.
• Ryan Richardson, MD
• Stephen Richardson, M.D.
• Richelle Moen, PHD LLC

• Certified Registered Nurse Anesthetist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Certified Registered Nurse Anesthetist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.