Individual provider Active NPI

Joanne E Heerwald, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Paul, MN
National Provider Identifier
1457352650
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R1024250 Issued in MN
Practice address
435 Phalen Blvd
St. Paul, MN 55130
Phone
(651) 254-8000
Fax
(651) 254-8084
NPI assigned
Aug 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 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 R1024250 MN Primary

Addresses

Primary practice location

435 Phalen Blvd
St. Paul, MN 55130

Mailing address

11223 Woods TRL N
Champlin, MN 55316-2681

Other identifiers 2

IdentifierTypeStateIssuer
46A73HEOtherMNBCBSMN
368722800MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060921000408 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668477852 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mngi Digestive Health PAGroup PAC ID 8123016557, 276 clinicians

Practice addresses (Care Compare)

3001 Broadway St NE
Suite 500
Minneapolis, MN 55413-2197
Phone (612) 871-1145

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1024250MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mngi Digestive Health, P.a. CurrentSince Apr 2, 2018 Accepting new patients
Regions Hospital CurrentSince Jul 1, 2006 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2018 Accepting new patients
Regions Hospital Current Accepting new patients
Regions Hospital CurrentSince Jul 1, 2006 Accepting new patients

Locations

9145 Springbrook Dr NW
Ste 200
Coon Rapids, MN 55433
Phone (612) 625-8999

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

3001 Broadway St NE
Ste 500
Minneapolis, MN 55413
Phone (612) 870-5557

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

15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008

15700 37th Ave N
Ste 300
Plymouth, MN 55446
Phone (612) 870-5555

2855 Campus Dr
Plymouth, MN 55441
Phone (763) 577-7000

435 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-3200

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1457352650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11223 WOODS TRL N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553162681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 PHALEN BLVD",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "55130",
            "telephone_number": "651-254-8000",
            "fax_number": "651-254-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEERWALD",
        "first_name": "JOANNE",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R1024250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMN",
            "identifier": "46A73HE",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "368722800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

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