Carl Green, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

12103 Issued in WI

Practice address

2321 Stout Road
Menomonie, WI 54751-5475

Phone

(715) 235-9671

NPI assigned

Jan 18, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI, WI2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mayo Clinic Health System-Northwest Wisconsin Region IncGroup PAC ID 4385553627, shared by 21 NPIs, 797 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Health System Eau Claire Hospital Hospital, Eau Claire, WI, CCN 520070

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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 and National Provider Directory roles.

• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Menomonie, WI
  • NPI 1154372944
  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Multi-Specialty Clinic/Center
  • Eau Claire, WI
  • NPI 1235588831
  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Bloomer, WI
  • NPI 1700837812
  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Barron, WI
  • NPI 1740239557
  Medicare reassignment NPD
• Aspirus Ironwood Hospital & Clinics, Inc.

  • Family Medicine Physician
  • Ironwood, MI
  • NPI 1992704753
  Medicare reassignment NPD
• Aspirus Ironwood Hospital & Clinics, Inc.

  • Critical Access Hospital
  • Ironwood, MI
  • NPI 1649297342
  Medicare reassignment
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Multi-Specialty Clinic/Center
  • Osseo, WI
  • NPI 1083140990
  NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Rural Health Clinic/Center
  • Mondovi, WI
  • NPI 1174116669
  NPD
• North American Partners in Anesthesia Wisconsin SC

  • Anesthesiology Physician
  • Eau Claire, WI
  • NPI 1720733454
  NPD
• Aspirus Ironwood Hospital & Clinics, Inc.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Ironwood, MI
  • NPI 1609743590
  NPD

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

• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • General Acute Care Hospital
  • Eau Claire, WI
  • NPI 1629027578
  Care Compare affiliation

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1316218639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 STOUT ROAD",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547515475",
            "telephone_number": "715-235-9671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N10561 Grandview Ln",
            "address_purpose": "LOCATION",
            "city": "Ironwood",
            "state": "MI",
            "postal_code": "499389622",
            "country_code": "US",
            "telephone_number": "906-932-2525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CARL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-18",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704199821",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "12103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgreen1800233@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "2321 Stout Road",
            "city": "Menomonie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547515475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Narda Gabriela Gordillo, B.S.
• Jendra Andrew Gosai, M.D.
• April Graese, OTR/L
• Marissa Ann Gramoll, MS
• Tracy Renee Grant, BA
• Gregory Eugene Green, D.D.S.
• Greenwood Chiropractic Health and Sports Performance LLC
• James Greenwood, DC
• Jennifer Guenther
• Heather N Gullickson-Cowden, OD

• Certified Registered Nurse Anesthetist in Menomonie, WI
• Providers in Menomonie, WI by specialty
• Certified Registered Nurse Anesthetist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.