Kelly Rae Peterson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

88989 Issued in MN

Practice address

9803 Vagabond LN N
Maple Grove, MN 55311-1364

Phone

(612) 242-1341

NPI assigned

Oct 13, 2011

Last updated

Jan 26, 2012By 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

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metropolitan Anesthesia Network LLPGroup PAC ID 5698689123, 516 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Metropolitan Anesthesia Network, LLP

  • Anesthesiology Physician
  • Plymouth, MN
  • NPI 1558314427

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Ridgeview Medical Center

  dba Ridgeview Medical Center CRNAs

  • Certified Registered Nurse Anesthetist
  • Waconia, MN
  • NPI 1528364429

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• University Anesthesia Providers, LLC

  • Anesthesiology Physician
  • Minneapolis, MN
  • NPI 1699711143

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Ridgeview Medical Center

  • Diagnostic Radiology Physician
  • Waconia, MN
  • NPI 1811174923
  NPD
• Cogent Healthcare of Washington, PC

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1861430522
  NPD (past)

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

• Ridgeview Medical Center

  • General Acute Care Hospital
  • Waconia, MN
  • NPI 1275608457
  Care Compare affiliation
• Ridgeview Medical Center

  • General Acute Care Hospital
  • Chaska, MN
  • NPI 1710748538
  Care Compare affiliation

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1336424027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9803 VAGABOND LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553111364",
            "telephone_number": "612-242-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9803 VAGABOND LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553111364",
            "telephone_number": "612-242-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KELLY",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-13",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "88989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth K. Peterson, MSW, LICSW
• Colleen Ann Peterson, RN
• Emily Jane Peterson, FNP
• Jennifer Kay Peterson, PT
• Katie Peterson
• Jennifer Petricig
• Heidi Petzel, DDS
• Jenna Pfeil
• Gregory J. Pflaster, M.D.
• Pha Care Services, Inc

• Certified Registered Nurse Anesthetist in Maple Grove, MN
• Providers in Maple Grove, 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 Jan 26, 2012; 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.