NPIMap

Individual provider Active NPI

Jason Ellingson, CRNA

  • Certified Registered Nurse Anesthetist
  • Rapid City, SD
National Provider Identifier
1366535973
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CR0000397 Issued in SD
Practice address
353 Fairmont Blvd
Rapid City, SD 57701
Phone
(605) 719-1000
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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 NP6356 SD
Certified Registered Nurse Anesthetist 367500000X R24634 ND
Certified Registered Nurse Anesthetist 367500000X CR0000397 SD Primary

Addresses

Primary practice location

353 Fairmont Blvd
Rapid City, SD 57701

Mailing address

353 Fairmont Blvd
Atten Medical Staff Services
Rapid City, SD 57701-6000

Other practice location 1

2305 37th Ave SW
Minot, ND 58701-7669
Phone (701) 857-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070518000287 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 0941220321 Reassigns benefits to 3 organizations
I20221109000144 NE Practitioner - Certified Registered Nurse Anesthetist (Crna) 0941220321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faith Regional Physician Services LLCGroup PAC ID 5193786168, 194 clinicians
Monument Health Rapid City Hospital IncGroup PAC ID 6002729506, 560 clinicians

Practice addresses (Care Compare)

2700 W Norfolk Ave
Faith Regional Health Services
Norfolk, NE 68701-4438
Phone (402) 371-4880

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (844) 641-5134

Hospital & facility affiliations

  • Monument Health Rapid City Hospital Hospital, Rapid City, SD, CCN 430077
  • Faith Health Hospital, Norfolk, NE, CCN 280125

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CR0000397SDMDCertified Registered Nurse Anesthetist
NP6356SDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North Platte Nebraska Hospital Corporation Current Accepting new patients
Faith Regional Physician Services, LLC CurrentSince Oct 30, 2022 Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Mar 15, 2001 Accepting new patients
Faith Regional Physician Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 30, 2022 Accepting new patients
Avera St. Mary'S CurrentSince Apr 3, 2019 Accepting new patients
North Platte Nebraska Hospital Corporation CurrentSince Apr 24, 2023 Accepting new patients
Peloton Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2021 Accepting new patients
Avera St Marys Nurse Anesthetist, Certified Registered CurrentSince Apr 3, 2019 Accepting new patients
Avera St Marys Current Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Mar 15, 2001 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Rushmore Ambulatory Surgery Center Past Accepting new patients
West River Anesthesiology Consultants PC Past Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

47452 268 Ave
Ste C
Humphrey, NE 68642
Phone (402) 923-0150

2700 W Norfolk Ave
Norfolk, NE 68701
Phone (402) 644-7131

2600 W Norfolk Ave
Ste 200
Norfolk, NE 68701
Phone (402) 844-8194

601 W Leota St
North Platte, NE 69101
Phone (308) 534-2288

2820 Mount Rushmore Rd
Rapid City, SD 57701
Phone (605) 721-8121

216 Anamaria Dr
Rapid City, SD 57701
Phone (605) 388-9440

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1366535973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "address_2": "ATTEN MEDICAL STAFF SERVICES",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57701",
            "telephone_number": "605-719-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2305 37th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587017669",
            "country_code": "US",
            "telephone_number": "701-857-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLINGSON",
        "first_name": "JASON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SD",
            "license": "NP6356",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R24634",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SD",
            "license": "CR0000397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.