Active NPI
Cody Crawford
- Certified Registered Nurse Anesthetist
- Minnetonka, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2383699
- Practice address
- 13911 Ridgedale Dr Ste 404B
Minnetonka, MN 55305-1777 - Phone
- (952) 932-9012
- NPI assigned
- Jan 11, 2019
- Last updated
- Jul 13, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, MN
Enrollment records 2
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2383699 | MN | MD | Certified Registered Nurse Anesthetist |
| R39886 | ND | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regional Anesthesia Services PA | Current | Accepting new patients | |
| Lakewood Health System | Current | Accepting new patients | |
| Lakewood Health System | Current | 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
- 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.
-
dba Lakewood Clinic Staples
- Rural Health Clinic/Center
- Staples, MN
- NPI 1841280823
-
dba Longbella Drug by Lakewood Health System - Pillager Clinic
- Community/Retail Pharmacy
- Pillager, MN
- NPI 1396519906
-
- Anesthesiology Physician
- Minnetonka, MN
- NPI 1073621850
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Staples, MN
- NPI 1295726362
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.