Wendy Amanda Gravelle, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R1540705 Issued in MN

Practice address

415 Jefferson St North
Wadena, MN 56482

Phone

(218) 631-3510

Fax

(218) 631-7496

NPI assigned

Sep 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Wendy Amanda Meyer Former name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Health of Northern MinnesotaGroup PAC ID 5597725168, 349 clinicians

Astera HealthGroup PAC ID 2961395272, shared by 8 NPIs, 106 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Bemidji Medical Center Hospital, Bemidji, MN, CCN 240100
• Astera Health Hospital, Wadena, MN, CCN 241354

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sanford Health of Northern Minnesota

  dba Sanford Health Kelliher Clinic

  • Family Medicine Physician
  • Kelliher, MN
  • NPI 1770849697
  Medicare reassignment Care Compare group
• Astera Health

  dba Astera Health Wadena Clinic

  • Rural Health Clinic/Center
  • Wadena, MN
  • NPI 1134305162
  Medicare reassignment NPD
• Astera Health

  dba Tri- County Health Care

  • Critical Access Hospital
  • Wadena, MN
  • NPI 1477545333
  Medicare reassignment NPD
• Perham Hospital District

  dba Perham Health

  • Critical Access Hospital
  • Perham, MN
  • NPI 1790799518
  Medicare reassignment NPD
• Perham Hospital District

  dba Perham Health

  • Chiropractor
  • Perham, MN
  • NPI 1932113768

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Perham Hospital District

  • Durable Medical Equipment & Medical Supplies
  • Perham, MN
  • NPI 1558630012
  NPD
• Sanford Health of Northern Minnesota

  dba Joe Lueken Cancer Center

  • Internal Medicine Physician
  • Bemidji, MN
  • NPI 1780628149
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Astera Health

  dba Tri- County Health Care

  • Critical Access Hospital
  • Wadena, MN
  • NPI 1477545333
  Care Compare affiliation
• Astera Health

  dba Astera Health Ottertail Clinic

  • Rural Health Clinic/Center
  • Ottertail, MN
  • NPI 1871546663

  Hospital

  Care Compare affiliation
• Sanford Health of Northern Minnesota

  dba Joe Lueken Cancer Center

  • Internal Medicine Physician
  • Bemidji, MN
  • NPI 1780628149

  Hospital

  Care Compare affiliation
• Sanford Health of Northern Minnesota

  dba Sanford Bemidji Medical Center

  • Rural Acute Care Hospital
  • Bemidji, MN
  • NPI 1801870191
  Care Compare affiliation

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306948245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13436 COUNTY ROAD 101",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "56482",
            "telephone_number": "218-632-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 JEFFERSON ST NORTH",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "56482",
            "telephone_number": "218-631-3510",
            "fax_number": "218-631-7496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVELLE",
        "first_name": "WENDY",
        "middle_name": "AMANDA",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R1540705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "MEYER",
            "middle_name": "AMANDA",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dana Forsberg
• Allison Jane Freese-Johnson
• Freshwater Education District
• Cheryl A Genoch, LADC
• Patricia Godwin
• Cheryl Lynn Greenwaldt, M.A., LPCC
• Rebecca Grieger
• Kassandra Grimes, RPH
• Grunst Chiropractic Clinic
• Jeffrey Alan Grunst, D.C.

• Certified Registered Nurse Anesthetist in Wadena, MN
• Providers in Wadena, 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 8, 2007; 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.