NPIMap

Individual provider Active NPI

Samuel Bernard Dunn, CRNA

  • Certified Registered Nurse Anesthetist
  • Greeley, CO
National Provider Identifier
1326628280
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0002941 Issued in CO
Practice address
1801 16TH St
Greeley, CO 80631-5154
Phone
(970) 810-4121
NPI assigned
Apr 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R045161 SD
Certified Registered Nurse Anesthetist 367500000X 0002941 CO Primary

Addresses

Primary practice location

1801 16TH St
Greeley, CO 80631-5154

Mailing address

5210 S Woodsedge TRL
Sioux Falls, SD 57108-8452
Phone (605) 929-4140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210524001207 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385043447 Reassigns benefits to 1 organization
I20230622002325 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385043447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

6100 S Louise Ave
Sioux Falls, SD 57108-6029

909 N Iowa Ave
Dell Rapids, SD 57022-1231
Phone (605) 428-5431

Hospital & facility affiliations

  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0002941COMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain State Anesthesia Providers Current Accepting new patients
Avera McKennan CurrentSince Jun 5, 2023 Accepting new patients
Rocky Mountain State Anesthesia Providers CurrentSince Jul 1, 2021 Accepting new patients
Avera McKennan Nurse Anesthetist, Certified Registered CurrentSince Jun 5, 2023 Accepting new patients
Avera McKennan Current Accepting new patients

Locations

4700 Lady Moon Dr
Fort Collins, CO 80528
Phone (970) 521-4600

5890 W 13th St
Ste 102
Greeley, CO 80634
Phone (970) 348-0090

5890 W 13th St
Greeley, CO 80634
Phone (970) 356-4567

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

2000 Boise Ave
Loveland, CO 80538
Phone (970) 635-4071

909 N Iowa Ave
Dell Rapids, SD 57022
Phone (605) 428-5431

Organizations & group practices 5

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1326628280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5210 S WOODSEDGE TRL",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088452",
            "telephone_number": "605-929-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315154",
            "telephone_number": "970-810-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNN",
        "first_name": "SAMUEL",
        "middle_name": "BERNARD",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R045161",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "0002941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.