Individual provider Active NPI

Lars Davidson, DNP

  • Certified Registered Nurse Anesthetist
  • Minneapolis, MN
National Provider Identifier
1447651765
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R177813-7 Issued in MN
Practice address
800 E 28TH St
Minneapolis, MN 55407-3723
Phone
(612) 863-4000
NPI assigned
Sep 5, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

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 R177813-7 MN Primary

Addresses

Primary practice location

800 E 28TH St
Minneapolis, MN 55407-3723

Mailing address

2828 Chicago Ave
Suite 300
Minneapolis, MN 55407-1544
Phone (612) 871-7639

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141121001778 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183946486 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Anesthesia Providers LLCGroup PAC ID 7315986064, 325 clinicians
Hennepin Healthcare System IncGroup PAC ID 4789684861, 905 clinicians

Practice addresses (Care Compare)

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 273-4097

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-6963

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1364MNMDMental Health Counselor
R177813-7MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 23, 2024 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Feb 3, 2020 Accepting new patients
Northwest Anesthesia P.a. Nurse Anesthetist, Certified Registered Past Accepting new patients
Northwest Anesthesia, P.a. Past Accepting new patients

Locations

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

8100 W 78th St
Ste 220
Minneapolis, MN 55439
Phone (952) 914-8400

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1447651765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 CHICAGO AVE",
            "address_2": "SUITE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071544",
            "telephone_number": "612-871-7639",
            "fax_number": "612-872-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "LARS",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-05",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R177813-7",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.