Individual provider Active NPI

Summer Flanders

  • Certified Registered Nurse Anesthetist
  • Minneapolis, MN
National Provider Identifier
1205575560
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
137043 Issued in CA
Practice address
2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone
(952) 992-5292
NPI assigned
Jun 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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 137043 CA Primary

Addresses

Primary practice location

2525 Chicago Ave
Minneapolis, MN 55404-4518

Mailing address

719 Loma Dr
Hermosa Beach, CA 90254-4656
Phone (310) 953-7753

Other identifiers 1

IdentifierTypeStateIssuer
137043OtherNBCRNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221115003560 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911375308 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2737MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Current Accepting new patients
Childrens Health Care CurrentSince Aug 29, 2022 Accepting new patients
Childrens Health Care CurrentSince Aug 29, 2022 Accepting new patients

Locations

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

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.

NPI Registry JSON

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1205575560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 LOMA DR",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902544656",
            "telephone_number": "310-953-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "952-992-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANDERS",
        "first_name": "SUMMER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-06-03",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "137043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBCRNA",
            "identifier": "137043",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.