Individual provider Active NPI

Patrick A Bailey, CRNA

  • Certified Registered Nurse Anesthetist
  • Cloquet, MN
National Provider Identifier
1194749267
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R123023-5 Issued in MN
Practice address
512 Skyline Blvd
Cloquet, MN 55720-3787
Phone
(218) 878-7699
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R123023-5 MN Primary

Addresses

Primary practice location

512 Skyline Blvd
Cloquet, MN 55720-3787

Mailing address

512 Skyline Blvd
Cloquet, MN 55720-3787
Phone (218) 878-7699

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040217000774 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648165852 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R123023-5MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Psych North PLLC CurrentSince Feb 22, 2022 Accepting new patients
Northland Anesthesia Associates Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2018 Accepting new patients
St. Luke'S Hospital of Duluth Past Accepting new patients
St. Luke'S Hospital of Duluth Nurse Anesthetist, Certified Registered PastSince Aug 27, 2012 Accepting new patients
Eir Med LLC PastSince Jun 1, 2022 Accepting new patients

Locations

10 5th St SE
Cook, MN 55723
Phone (218) 626-3441

1003 E Central Entrance
Duluth, MN 55811
Phone (218) 208-0019

1542 Golf Course Rd
Ste 105
Grand Rapids, MN 55744
Phone (218) 326-0667

1101 E 37th St
Ste 5
Hibbing, MN 55746
Phone (218) 208-0019

400 10th St E
Waconia, MN 55387

Organizations & group practices 5

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.

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": "1183852800000",
    "number": "1194749267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 SKYLINE BLVD",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557203787",
            "telephone_number": "218-878-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 SKYLINE BLVD",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557203787",
            "telephone_number": "218-878-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "PATRICK",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R123023-5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cloquet, MN

Sources for this page

  • 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.