Individual provider Active NPI

Twyla Wick, CRNA

  • Certified Registered Nurse Anesthetist
  • Jamestown, ND
National Provider Identifier
1194742866
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R28839 Issued in ND
Practice address
2422 20TH St SW
Jamestown, ND 58401-6201
Phone
(701) 952-4848
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R28839 ND Primary

Addresses

Primary practice location

2422 20TH St SW
Jamestown, ND 58401-6201

Mailing address

2422 20TH St SW
Jamestown, ND 58401-6201
Phone (701) 952-4848

Other names 1

  • Twyla Kouba Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060111001200 ND Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890718282 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutheran Charity AssociationGroup PAC ID 2264341031, shared by 6 NPIs, 168 clinicians

Practice addresses (Care Compare)

2422 20TH St SW
Jamestown, ND 58401-6201
Phone (701) 252-1050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R28839NDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Charity Association Current Accepting new patients
Lutheran Charity Association Current Accepting new patients
Lutheran Charity Association Nurse Anesthetist, Certified Registered CurrentSince May 27, 2016 Accepting new patients
Lutheran Charity Association CurrentSince May 27, 2016 Accepting new patients

Locations

2422 20th St SW
Jamestown, ND 58401
Phone (701) 252-1050

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1194742866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 20TH ST SW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584016201",
            "telephone_number": "701-952-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 20TH ST SW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584016201",
            "telephone_number": "701-952-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICK",
        "first_name": "TWYLA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R28839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TWYLA",
            "last_name": "KOUBA",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jamestown, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; 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.