Individual provider Active NPI

Cody Crawford

  • Certified Registered Nurse Anesthetist
  • Minnetonka, MN
National Provider Identifier
1437623535
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2383699 Issued in MN
Practice address
13911 Ridgedale Dr Ste 404B
Minnetonka, MN 55305-1777
Phone
(952) 932-9012
NPI assigned
Jan 11, 2019
Last updated
Jul 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R39886 ND
Certified Registered Nurse Anesthetist 367500000X 2383699 MN Primary

Addresses

Primary practice location

13911 Ridgedale Dr Ste 404B
Minnetonka, MN 55305-1777

Mailing address

1020 Ironwood Ave NW
Wadena, MN 56482-1020
Phone (218) 371-8898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190322000453 ND Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345580676
I20220816002983 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345580676 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakewood Health SystemGroup PAC ID 1052229671, 107 clinicians

Practice addresses (Care Compare)

49725 County
Suite 83
Staples, MN 56479-5280
Phone (218) 894-1515

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2383699MNMDCertified Registered Nurse Anesthetist
R39886NDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Anesthesia Services PA CurrentSince Jul 17, 2022 Accepting new patients
Lakewood Health System CurrentSince Jun 5, 2023 Accepting new patients
Lakewood Health System CurrentSince Jun 5, 2023 Accepting new patients

Locations

111 17th Ave E
Alexandria, MN 56308
Phone (320) 762-1511

13911 Ridgedale Dr
Ste 404B
Minnetonka, MN 55305
Phone (612) 636-0061

49725 County 83
Staples, MN 56479
Phone (218) 894-1033

Interoperability endpoints

  • Direct secure messaging: ccrawford613404@direct.centracare.com

Organizations & group practices 5

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 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": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1437623535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 IRONWOOD AVE NW",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821020",
            "telephone_number": "218-371-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13911 RIDGEDALE DR STE 404B",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051777",
            "telephone_number": "952-932-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "CODY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-11",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R39886",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "2383699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.