Active NPI
Richard John Jueneman, CRNA
- Certified Registered Nurse Anesthetist
- Marshall, MN
National Provider Identifier
1215906417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R-086801-9
- Practice address
- 300 S Bruce St
Marshall, MN 56258-1934 - Phone
- (507) 537-9114
- Fax
- (507) 537-9272
- NPI assigned
- Mar 17, 2006
- Last updated
- Jul 8, 2007
- 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 | R-086801-9 | MN | Primary |
Addresses
Primary practice location
300 S Bruce St
Marshall, MN 56258-1934
Mailing address
111 James Ave
Marshall, MN 56258-1638
Phone (507) 532-5979
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 437342100 | Medicaid | FM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-086801-9 | MN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sibley Medical Center | Past | Accepting new patients | |
| Midwest Anesthesia Services, LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Allina Health System | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Allina Health TeleRheumatology
- Rheumatology Physician
- Coon Rapids, MN
- NPI 1952146516
-
- Certified Registered Nurse Anesthetist
- Fairmont, MN
- NPI 1063765360
Nurse Anesthetist, Certified Registered
-
dba Ridgeview Sibley Medical Center - Swing
- Medicare Defined Swing Bed Hospital Unit
- Arlington, MN
- NPI 1003876491
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215906417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 JAMES AVE",
"city": "MARSHALL",
"state": "MN",
"postal_code": "562581638",
"telephone_number": "507-532-5979",
"fax_number": "507-929-4016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 S BRUCE ST",
"city": "MARSHALL",
"state": "MN",
"postal_code": "562581934",
"telephone_number": "507-537-9114",
"fax_number": "507-537-9272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUENEMAN",
"first_name": "RICHARD",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "R-086801-9",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "437342100",
"state": "FM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Marshall, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.