Phoutphong Manivong, DNP, ARPN, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

156072 Issued in MN

Practice address

5918 Crestwood CT
Saint Cloud, MN 56301-8850

Phone

(320) 493-2757

NPI assigned

Sep 6, 2025

Last updated

Dec 1, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Allina Health System

  dba Allina Health Buffalo Specialty Clinic

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment Care Compare group
• Certified Anesthesia Care, Co.

  dba Certified Anesthesia Care, Inc

  • Certified Registered Nurse Anesthetist
  • Stillwater, MN
  • NPI 1699736348

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• St Cloud Outpatient Surgery LTD

  • Ambulatory Surgical Clinic/Center
  • Saint Cloud, MN
  • NPI 1124084843
  Medicare reassignment NPD
• Allina Health System

  dba Buffalo Hospital CRNA

  • Certified Registered Nurse Anesthetist
  • Buffalo, MN
  • NPI 1649211756

  Nurse Anesthetist, Certified Registered

  NPD
• Allina Health System

  dba Allina Health TeleRheumatology

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD
• St Cloud Outpatient Surgery LTD

  dba St Cloud Surgical Center CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Cloud, MN
  • NPI 1720235419

  Nurse Anesthetist, Certified Registered

  NPD

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

{
    "created_epoch": "1757116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1447130620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5918 CRESTWOOD CT",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563018850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5918 CRESTWOOD CT",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563018850",
            "telephone_number": "320-493-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIVONG",
        "first_name": "PHOUTPHONG",
        "name_prefix": "Dr.",
        "credential": "DNP, ARPN, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-06",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "156072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Manders
• Kristen Manderschied, NP
• Madeline Mangin, MD
• Timothy Mangold, PA-C
• Lara Jean Manikowski
• Mankato Home Health Care, LLC
• Kelly Manley
• Angelia Cynthia Marie Mann
• Michael Fuad Mansour, MPT
• Manuel R Moran

• Certified Registered Nurse Anesthetist in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Certified Registered Nurse Anesthetist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.