Individual provider Active NPI

Sarah Wisdom, R.N., C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Eagan, MN
National Provider Identifier
1649668633
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
104982 Issued in MN
Practice address
2620 Eagan Woods Dr Ste 3005121
Eagan, MN 55121-1138
Phone
(651) 968-5201
NPI assigned
Dec 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 104982 MN Primary

Addresses

Primary practice location

2620 Eagan Woods Dr Ste 3005121
Eagan, MN 55121-1138

Mailing address

2620 Eagan Woods Dr Ste 300
Eagan, MN 55121-1138
Phone (651) 968-5201

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150417000849 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395063614 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Mngi Digestive Health, P.a. CurrentSince Sep 29, 2020 Accepting new patients
Certified Anesthesia Care, Co. Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2020 Accepting new patients

Locations

5705 W Old Shakopee Rd
Ste 150
Bloomington, MN 55437
Phone (612) 870-5530

9801 DuPont Ave S
Ste 100
Bloomington, MN 55431

1185 Town Centre Dr
Ste 205
Eagan, MN 55123

2620 Eagan Woods Dr
Ste 300
Eagan, MN 55121
Phone (651) 968-5215

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

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

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

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

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

400 10th St E
Waconia, MN 55387

237 Radio Dr
Ste 200
Woodbury, MN 55125

Interoperability endpoints

  • Direct secure messaging: sarah.wisdom.p4@direct.tcpain.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1419811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1649668633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 EAGAN WOODS DR STE 300",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211138",
            "telephone_number": "651-968-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 EAGAN WOODS DR STE 3005121",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211138",
            "telephone_number": "651-968-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISDOM",
        "first_name": "SARAH",
        "credential": "R.N., C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "104982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.