Individual provider Active NPI

Ekaterina Vladimirovna McHenry, APRN, CRNA

  • Certified Registered Nurse Anesthetist
  • Duluth, MN
National Provider Identifier
1396281978
Registry record updated May 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
114702 Issued in MN
Practice address
400 E 3Rd St
Essentia Health Duluth Clinic
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
Jan 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2017

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 CRNA2055 MN
Certified Registered Nurse Anesthetist 367500000X 203970 MN
Certified Registered Nurse Anesthetist 367500000X 114702 MN Primary

Addresses

Primary practice location

400 E 3Rd St
Essentia Health Duluth Clinic
Duluth, MN 55805-1951

Mailing address

400 E 3Rd St
Duluth Clinic
Duluth, MN 55805-1951
Phone (218) 786-8364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170523001589 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284901299 Reassigns benefits to 3 organizations
I20200624000517 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284901299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, shared by 25 NPIs, 1,135 clinicians

Practice addresses (Care Compare)

3500 Tower Ave
Superior, WI 54880-5335
Phone (715) 395-5454

400 1St Ave SW
Chisholm, MN 55719-2081
Phone (218) 254-3316

Hospital & facility affiliations

  • Essentia Health St Mary'S Medical Center Hospital, Duluth, MN, CCN 240002
  • Essentia Health Duluth Hospital, Duluth, MN, CCN 240019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
114702MNMDCertified Registered Nurse Anesthetist
203970MNMDCertified Registered Nurse Anesthetist
CRNA2055MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Anesthesia P.a Nurse Anesthetist, Certified Registered CurrentSince Oct 5, 2021 Accepting new patients
The Duluth Clinic, LTD Nurse Anesthetist, Certified Registered CurrentSince Jun 22, 2020 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic, LTD Nurse Anesthetist, Certified Registered CurrentSince Apr 17, 2017 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Jan 10, 2022 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Jan 10, 2022 Accepting new patients
St. Luke'S Hospital of Duluth Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Apr 17, 2017 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

400 E 3rd St
#2
Duluth, MN 55805
Phone (218) 786-8319

1420 London Rd
Ste 100
Duluth, MN 55805
Phone (218) 728-0650

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

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

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

1101 9th St N
Virginia, MN 55792
Phone (218) 305-0000

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 9

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 2

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": "1483660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495756800000",
    "number": "1396281978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "address_2": "DULUTH CLINIC",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "address_2": "ESSENTIA HEALTH DULUTH CLINIC",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCHENRY",
        "first_name": "EKATERINA",
        "middle_name": "VLADIMIROVNA",
        "credential": "APRN, CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-06",
        "last_updated": "2017-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "CRNA2055",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "203970",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "114702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2017; 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.