Individual provider Active NPI

Crystal Vigdal, DNAP, RN, CRNA

  • Certified Registered Nurse Anesthetist
  • Sioux City, IA
National Provider Identifier
1417523218
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
D163641 Issued in IA
Practice address
2720 Stone Park Blvd
Sioux City, IA 51104-3734
Phone
(712) 279-3290
NPI assigned
Jun 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X D163641 IA Primary

Addresses

Primary practice location

2720 Stone Park Blvd
Sioux City, IA 51104-3734

Mailing address

705 S Tama St
Rock Rapids, IA 51246-1916
Phone (515) 979-0473

Other names 1

  • Crystal Knutson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210715003292 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325440183 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consultants PCGroup PAC ID 6103716626, 20 clinicians

Practice addresses (Care Compare)

2720 Stone Park Blvd
Sioux City, IA 51104-3734
Phone (712) 259-3000

Hospital & facility affiliations

  • St Lukes Regional Medical Center Hospital, Sioux City, IA, CCN 160146

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D163641IAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Consultants PC Anesthesiology CurrentSince Jul 12, 2021 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients

Locations

2730 Pierce St
Sioux City, IA 51104
Phone (712) 224-3380

2730 Pierce St
Ste 100
Sioux City, IA 51104
Phone (712) 294-7693

2720 Stone Park Blvd
Sioux City, IA 51104
Phone (712) 259-3000

Interoperability endpoints

  • Direct secure messaging: cvigdal837060@direct.unitypoint.org

Organizations & group practices 3

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 1

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": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1417523218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 S TAMA ST",
            "city": "ROCK RAPIDS",
            "state": "IA",
            "postal_code": "512461916",
            "telephone_number": "515-979-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 STONE PARK BLVD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043734",
            "telephone_number": "712-279-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGDAL",
        "first_name": "CRYSTAL",
        "credential": "DNAP, RN, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D163641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "KNUTSON",
            "credential": "BSN, RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.

Verify at the official NPI Registry.