Active NPI
Jeanne M Hendricks, C.R.N.A.
- Certified Registered Nurse Anesthetist
- St Louis Park, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R 097605-3
- Practice address
- 6500 Excelsior Blvd
St Louis Park, MN 55426-4702 - Phone
- (952) 993-6016
- NPI assigned
- Jan 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R 097605-3 | MN | Primary |
Addresses
Primary practice location
6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Mailing address
6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 359823300 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
14700 28TH Ave N
Suite 20
Plymouth, MN 55447-4876
1613 Utah Dr S
St Louis Park, MN 55426-1924
400 E 10TH St
Waconia, MN 55387-4552
8900 Springbrook Dr NW
Suite 250
Coon Rapids, MN 55433-5884
Hospital & facility affiliations
- Abbott Northwestern Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1384 | MN | MD | Physical Therapist |
| R 097605-3 | MN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metropolitan Anesthesia Network, LLP | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700
4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786
2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800
2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813
2855 Campus Dr
Plymouth, MN 55441
Phone (763) 577-7000
14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779
1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200
6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246
Organizations & group practices 4
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.
-
- Obstetrics & Gynecology Physician
- Buffalo, MN
- NPI 1295272342
-
- Anesthesiology Physician
- Plymouth, MN
- NPI 1558314427
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Cambridge, MN
- NPI 1922402718
Nurse Anesthetist, Certified Registered
-
- Rheumatology Physician
- Coon Rapids, MN
- NPI 1952146516
Hospital & facility affiliations 23
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Obesity Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1154684835
Hospital
-
- Physical Medicine & Rehabilitation Physician
- Minneapolis, MN
- NPI 1275577215
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476144000000",
"number": "1528047453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6500 EXCELSIOR BLVD",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554264702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6500 EXCELSIOR BLVD",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554264702",
"telephone_number": "952-993-6016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICKS",
"first_name": "JEANNE",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "C.R.N.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-10",
"last_updated": "2016-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "R 097605-3",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "359823300",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; 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.