Individual provider Active NPI

Nicole Nash, DNP, APRN, CRNA

  • Certified Registered Nurse Anesthetist
  • Glencoe, MN
National Provider Identifier
1285120477
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2235 Issued in MN
Practice address
1805 Hennepin Ave N
Glencoe, MN 55336
Phone
(320) 864-3121
NPI assigned
Jul 10, 2018
Last updated
Sep 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2235 MN Primary
Critical Care Medicine Registered Nurse 163WC0200X 1905175 MN

Addresses

Primary practice location

1805 Hennepin Ave N
Glencoe, MN 55336

Mailing address

2654 Eitel Rd
Chaska, MN 55318-1504
Phone (612) 702-2403

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181130002095 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496099558 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glencoe Regional Health ServicesGroup PAC ID 1759292980, 45 clinicians

Practice addresses (Care Compare)

1805 Hennepin Ave N
Glencoe, MN 55336-1416
Phone (320) 864-3121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2235MNMDMarriage & Family Therapist
1905175MNMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Glencoe Regional Health Services CurrentSince Oct 8, 2018 Accepting new patients
Glencoe Regional Health Services CurrentSince Oct 8, 2018 Accepting new patients
University Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 11, 2019 Accepting new patients

Locations

1805 Hennepin Ave N
Glencoe, MN 55336
Phone (320) 864-3121

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

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

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.

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": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1285120477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2654 EITEL RD",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181504",
            "telephone_number": "612-702-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 HENNEPIN AVE N",
            "city": "GLENCOE",
            "state": "MN",
            "postal_code": "55336",
            "telephone_number": "320-864-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASH",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "2235",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MN",
            "license": "1905175",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glencoe, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.