NPIMap

Organization Active NPI

Red River Anesthesia P C

  • Certified Registered Nurse Anesthetist
  • Breckenridge, MN
National Provider Identifier
1295842623
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
RED RIVER ANESTHESIA P C
Practice address
2400 St Francis Dr
Breckenridge, MN 56520-1025
Phone
(218) 643-3000
NPI assigned
Aug 23, 2006
Last updated
Nov 16, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Authorized official

Name
Robert Splichal, C.R.N.A.NPI 1689781171
Title
Manager
Phone
(574) 268-9640

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X MN Primary

Addresses

Primary practice location

2400 St Francis Dr
Breckenridge, MN 56520-1025

Mailing address

PO Box 1296
Warsaw, IN 46581-1296
Phone (574) 268-9640

Other identifiers 5

IdentifierTypeStateIssuer
CG1606OtherMNPALMETTO GPA - MEDICARE RAIL ROAD
22L73REOtherMNBLUE CROSS BLUE SHIELD BLUE PLUS OF MINNESOTA
CG1606OtherNDPALMETTO GPA - MEDICARE RAIL ROAD
053783700MedicaidMN
11090MedicaidND

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1295842623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1296",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465811296",
            "telephone_number": "574-268-9640",
            "fax_number": "574-268-0684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 ST FRANCIS DR",
            "city": "BRECKENRIDGE",
            "state": "MN",
            "postal_code": "565201025",
            "telephone_number": "218-643-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED RIVER ANESTHESIA P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "SPLICHAL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "574-268-9640",
        "authorized_official_credential": "C.R.N.A."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GPA - MEDICARE RAIL ROAD",
            "identifier": "CG1606",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD BLUE PLUS OF MINNESOTA",
            "identifier": "22L73RE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GPA - MEDICARE RAIL ROAD",
            "identifier": "CG1606",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "053783700",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11090",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Breckenridge, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.