Individual provider Active NPI

Russell Alan Hauge, CRNA

  • Certified Registered Nurse Anesthetist
  • Elkhart, IN
National Provider Identifier
1619939501
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA0267 Issued in AZ
Practice address
600 East Blvd
Elkhart, IN 46514-2483
Phone
(574) 524-8130
Fax
(574) 524-8138
NPI assigned
Apr 5, 2006
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 120711-6 MN
Certified Registered Nurse Anesthetist 367500000X 4677 WI
Certified Registered Nurse Anesthetist 367500000X 28195266A IN
Certified Registered Nurse Anesthetist 367500000X CRNA0267 AZ Primary

Addresses

Primary practice location

600 East Blvd
Elkhart, IN 46514-2483

Mailing address

4864 Crown LN
Woodbury, MN 55129-8900
Phone (651) 459-8513

Other practice location 1

350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone (602) 406-3000

Other practice location 2

4864 Crown Ln
Woodbury, MN 55129-8900
Phone (651) 459-8513

Other identifiers 1

IdentifierTypeStateIssuer
201026230MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, TN, NV3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040124000264 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981506300 Reassigns benefits to 1 organization
I20250218000611 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981506300 Reassigns benefits to 1 organization
I20250331002602 NV Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981506300 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1509MNMDAcupuncturist
CRNA0267AZMDCertified Registered Nurse Anesthetist
120711-6MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Carson Tahoe Physician Hospital Organization, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 24, 2025 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2025 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Feb 1, 2025 Accepting new patients
St Francis Medical Center Past Accepting new patients
Hoosier Anesthesia Associates PC Past Accepting new patients
Premier Anesthesia of Indiana PC Past Accepting new patients

Locations

1600 Medical Pkwy
Carson City, NV 89703
Phone (775) 220-9149

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

941 Spring Creek Rd
East Ridge, TN 37412
Phone (423) 855-3255

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1619939501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4864 CROWN LN",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551298900",
            "telephone_number": "651-459-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 EAST BLVD",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142483",
            "telephone_number": "574-524-8130",
            "fax_number": "574-524-8138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 W Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850134409",
            "country_code": "US",
            "telephone_number": "602-406-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4864 Crown Ln",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551298900",
            "country_code": "US",
            "telephone_number": "651-459-8513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUGE",
        "first_name": "RUSSELL",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "120711-6",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "4677",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28195266A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "CRNA0267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201026230",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.