Burton P Fosse Jr., CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R0636746 Issued in MN

Practice address

600 Pleasant Ave S
Park Rapids, MN 56470-1431

Phone

(218) 732-9464

Fax

(218) 732-0249

NPI assigned

Jun 22, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

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.

• Northland Anesthesia Associates

  • Certified Registered Nurse Anesthetist
  • Cook, MN
  • NPI 1275073892

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1285630525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 432",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564700432",
            "telephone_number": "218-732-9464",
            "fax_number": "218-732-0249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PLEASANT AVE S",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701431",
            "telephone_number": "218-732-9464",
            "fax_number": "218-732-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSSE",
        "first_name": "BURTON",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R0636746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "55G94FO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00016147",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Five Star Living of Park Rapids, LLC (Diamond Willow Assisted Living)
• Five Star Living of Park Rapids, LLC (Diamond Willow Assisted Living)
• Constance Margaret Ford
• Heather Foresman, APRN,CNM
• Codruta Iuliana Fosman, DDS
• Monica M Foster, LRD/CDE
• Mary Patricia Frenzel, PH.D.
• Caleb T Fritel, DPT
• Katherine L Fritsch, MA, LADC, LPCC
• Fulfilled Family Chiropractic PLLC

• Certified Registered Nurse Anesthetist in Park Rapids, MN
• Providers in Park Rapids, MN by specialty
• Certified Registered Nurse Anesthetist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.