Individual provider Active NPI

Gram M Cotton, CRNA, DNAP, APNP

  • Certified Registered Nurse Anesthetist
  • Minneapolis, MN
National Provider Identifier
1326052424
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R143404-4 Issued in MN
Practice address
2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone
(612) 262-5000
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4174-33 WI
Certified Registered Nurse Anesthetist 367500000X 175478-30 WI
Certified Registered Nurse Anesthetist 367500000X R143404-4 MN Primary

Addresses

Primary practice location

2925 Chicago Ave
Minneapolis, MN 55407-1321

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000

Other identifiers 1

IdentifierTypeStateIssuer
166955900MedicaidMN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gcotton391912@direct-ehr-ssmhc.com Direct AGNESIAN HEALTHCARE INC
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other AGNESIAN HEALTHCARE INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110308000315 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234140278 Reassigns benefits to 1 organization
I20220321001085 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234140278 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R143404-4MNMDCertified Registered Nurse Anesthetist
175478-30WIMDCertified Registered Nurse Anesthetist
4174-33WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Quantum Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 14, 2021 Accepting new patients
Ear Nose and Throat Family Clinic of Wisconsin SC CurrentSince Jan 1, 2024 Accepting new patients
Lifeline Medical Associates, LLC Past Accepting new patients
Certified Anesthesia Care, Co. Nurse Anesthetist, Certified Registered Past Accepting new patients
St Clare Memorial Hospital, Inc. Past Accepting new patients
Seven Hills Anesthesia, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3228 N Lincoln Ave
Chicago, IL 60657
Phone (312) 480-1387

114 W Rockland Rd
Libertyville, IL 60048
Phone (773) 267-0554

250 W Kensington Rd
Ste 3B
Mount Prospect, IL 60056
Phone (262) 652-2887

250 W Kensington Rd
Ste B
Mount Prospect, IL 60056
Phone (847) 649-6288

250 W Kensington Rd
Ste 1A
Mt Prospect, IL 60056
Phone (847) 305-8600

814 E Woodfield Rd
Schaumburg, IL 60173
Phone (224) 347-4875

1375 E Woodfield Rd
Ste 120
Schaumburg, IL 60173
Phone (847) 882-5888

8930 Gross Point Rd
Ste 700
Skokie, IL 60077
Phone (847) 966-8930

6127 Green Bay Rd
Ste 100
Kenosha, WI 53142
Phone (262) 652-2887

8870 S Mayhew Dr
Ste 300
Oak Creek, WI 53154
Phone (262) 652-2887

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1326052424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTON",
        "first_name": "GRAM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "CRNA, DNAP, APNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "4174-33",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "175478-30",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R143404-4",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166955900",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gcotton391912@direct-ehr-ssmhc.com",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "gcotton391912@direct-ehr-ssmhc.com",
            "address_1": "620 W Brown St",
            "city": "Waupun",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539631702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "620 W Brown St",
            "city": "Waupun",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539631702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.