Active NPI
Amy Josephine Henderson, CRNA
- Certified Registered Nurse Anesthetist
- Coon Rapids, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 090378
- Practice address
- 8990 Springbrook Dr NW
Suite 250
Coon Rapids, MN 55433-5850 - Phone
- (763) 398-1176
- Fax
- (763) 398-0124
- NPI assigned
- Aug 16, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R1563313 | MN | |
| Certified Registered Nurse Anesthetist | 367500000X | 090378 | MN | Primary |
Addresses
Primary practice location
8990 Springbrook Dr NW
Suite 250
Coon Rapids, MN 55433-5850
Mailing address
8990 Springbrook Dr NW
Suite 250
Coon Rapids, MN 55433-5850
Phone (763) 398-1176
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
8650 Hudson Blvd N
Suite 235
Lake Elmo, MN 55042-8480
Phone (651) 702-7400
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1563313 | MN | MD | Registered Nurse |
| 090378 | MN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metropolitan Anesthesia Network, LLP | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
8650 Hudson Blvd N
Ste 235
Lake Elmo, MN 55042
Phone (651) 203-4673
4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786
2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800
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.
-
- Anesthesiology Physician
- Plymouth, MN
- NPI 1558314427
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Addiction (Substance Use Disorder) Psychologist
- Fridley, MN
- NPI 1083197214
Hospital
-
- General Acute Care Hospital
- Cambridge, MN
- NPI 1215755400
-
- Substance Use Disorder Rehabilitation Hospital Unit
- Fridley, MN
- NPI 1285692145
-
- General Acute Care Hospital
- Coon Rapids, MN
- NPI 1316904287
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fridley, MN
- NPI 1598700528
Hospital
-
- Psychiatric Hospital Unit
- Fridley, MN
- NPI 1609056100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345075200000",
"number": "1306194717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8990 SPRINGBROOK DR NW",
"address_2": "SUITE 250",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554335850",
"telephone_number": "763-398-1176",
"fax_number": "763-398-0124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8990 SPRINGBROOK DR NW",
"address_2": "SUITE 250",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554335850",
"telephone_number": "763-398-1176",
"fax_number": "763-398-0124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "AMY",
"middle_name": "JOSEPHINE",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-16",
"last_updated": "2012-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MN",
"license": "R1563313",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "090378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; 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.