Active NPI
Nicole Marie McCracken, CRNA
- Certified Registered Nurse Anesthetist
- Robbinsdale, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2548
- Practice address
- 3300 Oakdale Ave N
Robbinsdale, MN 55422-2926 - Phone
- (763) 520-5200
- NPI assigned
- Jan 7, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 2548 | MN | Primary |
Addresses
Primary practice location
3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Mailing address
117 126TH LN NW
Coon Rapids, MN 55448-1542
Phone (952) 406-0628
Other names 1
- Nicole Marie Jackson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9875 Hospital Dr
Maple Grove, MN 55369-4648
Phone (763) 898-1000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2548 | MN | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mngi Digestive Health, P.a. | Current | Accepting new patients | |
| Anesthesiology, P.a. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
9145 Springbrook Dr NW
Ste 200
Coon Rapids, MN 55433
Phone (612) 625-8999
9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000
3001 Broadway St NE
Ste 500
Minneapolis, MN 55413
Phone (612) 870-5557
14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779
15700 37th Ave N
Ste 300
Plymouth, MN 55446
Phone (612) 870-5555
15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008
3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Robbinsdale, MN
- NPI 1013960798
Nurse Anesthetist, Certified Registered
-
- Gastroenterology Physician
- Minneapolis, MN
- NPI 1609804541
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Maple Grove, MN
- NPI 1225272552
-
dba North Memorial Ambulance Service
- Ambulance
- Brooklyn Center, MN
- NPI 1538195912
Hospital
-
dba North Memorial Health Specialty Center - Robbinsdale
- Medical Specialty Clinic/Center
- Robbinsdale, MN
- NPI 1699953000
Hospital
-
dba North Memorial Health Hospital
- General Acute Care Hospital
- Robbinsdale, MN
- NPI 1851344907
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609977600000",
"number": "1396333050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 126TH LN NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554481542",
"telephone_number": "952-406-0628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 OAKDALE AVE N",
"city": "ROBBINSDALE",
"state": "MN",
"postal_code": "554222926",
"telephone_number": "763-520-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCRACKEN",
"first_name": "NICOLE",
"middle_name": "MARIE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-07",
"last_updated": "2021-01-07",
"certification_date": "2021-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "2548",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "JACKSON",
"middle_name": "MARIE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Robbinsdale, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.