Individual provider Active NPI

Lynn M Reynolds Cooley

  • Certified Registered Nurse Anesthetist
  • Grand Forks, ND
National Provider Identifier
1326083460
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R23311 Issued in ND
Practice address
1000 South Columbia Road
Grand Forks, ND 58206-6002
Phone
(701) 780-5000
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R23311 ND
Certified Registered Nurse Anesthetist 367500000X 100859 NE
Anesthesiologist Assistant 367H00000X R23311 ND
Certified Registered Nurse Anesthetist 367500000X R23311 ND Primary

Addresses

Primary practice location

1000 South Columbia Road
Grand Forks, ND 58206-6002

Mailing address

PO Box 6002
Grand Forks, ND 58206-6002
Phone (701) 780-5000

Other names 1

  • Lynn Reynolds Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041217000719 ND Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840192100 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovis Health LLCGroup PAC ID 9931298155, 561 clinicians

Practice addresses (Care Compare)

3000 32ND Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R23311NDMDRegistered Nurse
1629MNMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital of Devils Lake CurrentSince Aug 12, 2018 Accepting new patients
Mercy Hospital of Devils Lake Current Accepting new patients
Mercy Hospital of Devils Lake CurrentSince Aug 12, 2018 Accepting new patients
Innovis Health LLC CurrentSince Oct 13, 2020 Accepting new patients
Innovis Health LLC CurrentSince Oct 13, 2020 Accepting new patients
Innovis Health, LLC Current Accepting new patients
Anesthesia Group of Grand Island PC Past Accepting new patients
St. Luke'S Hospital of Duluth Past Accepting new patients

Locations

3290 Solutions Ctr
Chicago, IL 60677

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

1031 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2131

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1326083460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6002",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582066002",
            "telephone_number": "701-780-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SOUTH COLUMBIA ROAD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582066002",
            "telephone_number": "701-780-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS COOLEY",
        "first_name": "LYNN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R23311",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "100859",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "ND",
            "license": "R23311",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R23311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "REYNOLDS",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.