NPIMap

Individual provider Active NPI

Jeremy Joseph Eversvik, CRNA

  • Certified Registered Nurse Anesthetist
  • Crookston, MN
National Provider Identifier
1437345295
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP 9290976 Issued in FL
Practice address
323 S Minnesota St
Crookston, MN 56716-1601
Phone
(218) 281-9200
Fax
(218) 281-9224
NPI assigned
Sep 14, 2007
Last updated
Feb 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2014

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 R29075 ND
Certified Registered Nurse Anesthetist 367500000X ARNP 9290976 FL Primary
Certified Registered Nurse Anesthetist 367500000X R 176359-5 MN

Addresses

Primary practice location

323 S Minnesota St
Crookston, MN 56716-1601

Mailing address

323 S Minnesota St
Crookston, MN 56716-1601
Phone (218) 281-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120316000592 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618062480 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of North Dakota School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverview Healthcare AssociationGroup PAC ID 7810806718, 46 clinicians

Practice addresses (Care Compare)

323 S Minnesota St
Crookston, MN 56716-1601
Phone (218) 281-9200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.91 of 100Reported as group
Quality
88.07
Promoting interoperability
100
Improvement activities
40
Cost
74.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
ARNP 9290976FLMDCertified Registered Nurse Anesthetist
R 176359-5MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverview Healthcare Association CurrentSince Dec 15, 2011 Accepting new patients
Riverview Healthcare Association CurrentSince Dec 15, 2011 Accepting new patients
Riverview Healthcare Association Current Accepting new patients

Locations

323 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9200

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1437345295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S MINNESOTA ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567161601",
            "telephone_number": "218-281-9200",
            "fax_number": "218-281-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 S MINNESOTA ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567161601",
            "telephone_number": "218-281-9200",
            "fax_number": "218-281-9224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERSVIK",
        "first_name": "JEREMY",
        "middle_name": "JOSEPH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-14",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R29075",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP 9290976",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R 176359-5",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crookston, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.