NPIMap

Organization Active NPI

Lutheran Charity Association

Doing business as Jamestown Regional Medical Center CRNA

  • Certified Registered Nurse Anesthetist
  • Jamestown, ND
National Provider Identifier
1407957277
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
LUTHERAN CHARITY ASSOCIATION
Doing business as
Jamestown Regional Medical Center CRNA
Practice address
2422 20TH St SW
Jamestown, ND 58401-6201
Phone
(701) 252-1050
Fax
(701) 952-3265
NPI assigned
Sep 26, 2006
Last updated
Apr 1, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
JAMESTOWN REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Authorized official

Name
Mr. Michael J Delfs
Title
Ceo
Phone
(701) 952-4850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

2422 20TH St SW
Jamestown, ND 58401-6201

Mailing address

2422 20TH St SW
Jamestown, ND 58401-6201
Phone (701) 252-1050

Other names 1

  • Jamestown Regional Medical Center CRNA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040128000565 ND Part B Supplier - Clinic/Group Practice 2264341031 Receives reassigned benefits from 93 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bismarck, ND; Carrington, ND; Jamestown, ND

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Jamestown Hospital7 organizations share this tax ID, including this one
Part of
Jamestown Hospital

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

  • Deanna M Balvitsch, CRNA
    • Certified Registered Nurse Anesthetist
    • Fargo, ND
    • NPI 1124045117

    Nurse Anesthetist, Certified Registered

    NPD
  • Jodee L Blaze, CRNA
    • Certified Registered Nurse Anesthetist
    • Fargo, ND
    • NPI 1093955593

    Nurse Anesthetist, Certified Registered

    NPD
  • Allyssa Ann Leininger
    • Certified Registered Nurse Anesthetist
    • Jamestown, ND
    • NPI 1841763232

    Nurse Anesthetist, Certified Registered

    NPD
  • James Martin Metzger, CRNA
    • Certified Registered Nurse Anesthetist
    • Jamestown, ND
    • NPI 1548407372

    Nurse Anesthetist, Certified Registered

    NPD
  • Marco Moser, CRNA
    • Certified Registered Nurse Anesthetist
    • Jamestown, ND
    • NPI 1437467073

    Nurse Anesthetist, Certified Registered

    NPD
  • Tami O Rasmussen, CRNA
    • Certified Registered Nurse Anesthetist
    • Fargo, ND
    • NPI 1437171006

    Nurse Anesthetist, Certified Registered

    NPD
  • Sara J Skatvold, CRNA
    • Certified Registered Nurse Anesthetist
    • Fargo, ND
    • NPI 1770860322

    Nurse Anesthetist, Certified Registered

    NPD
  • Nina Wentz, CRNA
    • Certified Registered Nurse Anesthetist
    • Fargo, ND
    • NPI 1407128135

    Nurse Anesthetist, Certified Registered

    NPD
  • Twyla Wick, CRNA
    • Certified Registered Nurse Anesthetist
    • Jamestown, ND
    • NPI 1194742866

    Nurse Anesthetist, Certified Registered

    NPD
  • Andrew L Schott, CRNA
    • Certified Registered Nurse Anesthetist
    • Aberdeen, SD
    • NPI 1891068045

    Nurse Anesthetist, Certified Registered

    NPD

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1407957277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 20TH ST SW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584016201",
            "telephone_number": "701-252-1050",
            "fax_number": "701-952-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 20TH ST SW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584016201",
            "telephone_number": "701-252-1050",
            "fax_number": "701-952-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN CHARITY ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JAMESTOWN REGIONAL MEDICAL CENTER",
        "enumeration_date": "2006-09-26",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "DELFS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "701-952-4850",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jamestown Regional Medical Center CRNA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jamestown Regional Medical Center CRNA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jamestown, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.