Individual provider Active NPI

Renea Marie Palmer, CRNA

  • Certified Registered Nurse Anesthetist
  • Edina, MN
National Provider Identifier
1255386207
Registry record updated Aug 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R1374256 Issued in MN
Practice address
6401 France Ave So.
Edina, MN 55435-2104
Phone
(952) 924-5185
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2011

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 R1374256 MN Primary

Addresses

Primary practice location

6401 France Ave So.
Edina, MN 55435-2104

Mailing address

6401 France Ave So.
Fairwiew Southdale Hospital
Edina, MN 55435-2104
Phone (952) 924-5185

Other names 1

  • Renea Marie Woodland Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060331000031 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991713067 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1429MNMDNurse Practitioner
R1374256MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2020 Accepting new patients

Locations

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

Organizations & group practices 1

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1255386207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 FRANCE AVE SO.",
            "address_2": "FAIRWIEW SOUTHDALE HOSPITAL",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352104",
            "telephone_number": "952-924-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 FRANCE AVE SO.",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352104",
            "telephone_number": "952-924-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "RENEA",
        "middle_name": "MARIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R1374256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEA",
            "last_name": "WOODLAND",
            "middle_name": "MARIE",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; 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.