Individual provider Active NPI

Ryan Berry

  • Certified Registered Nurse Anesthetist
  • Minneapolis, MN
National Provider Identifier
1609231877
Registry record updated Oct 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1864 Issued in MN
Practice address
800 E 28TH St
Minneapolis, MN 55407-3723
Phone
(865) 342-8900
Fax
(865) 691-0843
NPI assigned
Dec 15, 2015
Last updated
Oct 31, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2017

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 1864 MN Primary

Addresses

Primary practice location

800 E 28TH St
Minneapolis, MN 55407-3723

Mailing address

8942 Knollwood Dr
Eden Prairie, MN 55347-1722

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220503000343 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305140260 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Memorial Medical CenterGroup PAC ID 7315835949, 131 clinicians

Practice addresses (Care Compare)

2204 Eastland Dr
Bloomington, IL 61704-3567
Phone (309) 663-0222

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

701 N 1St St
Springfield, IL 62781-0001
Phone (217) 788-3755

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Schuyler County Hospital District CurrentSince Jul 10, 2023 Accepting new patients
Carle Health Medical Group CurrentSince Oct 4, 2025 Accepting new patients
Schuyler County Hospital District CurrentSince Jul 10, 2023 Accepting new patients
Memorial Medical Center Nurse Anesthetist, Certified Registered CurrentSince Apr 25, 2022 Accepting new patients
Carle West Physician Group Inc CurrentSince Dec 11, 2023 Accepting new patients
Memorial Medical Center CurrentSince Apr 25, 2022 Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

238 S Congress St
Rushville, IL 62681
Phone (217) 322-4321

701 N 1st St
Springfield, IL 62781
Phone (217) 788-3100

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: rberrycrna395380@carlehiedirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1450137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1609231877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8942 KNOLLWOOD DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553471722"
        },
        {
            "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": "865-342-8900",
            "fax_number": "865-691-0843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-15",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "1864",
            "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 Oct 31, 2017; 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.