Individual provider Active NPI

Kathryn Sheehan Menne

  • Certified Registered Nurse Anesthetist
  • Hugo, MN
National Provider Identifier
1659634855
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R 174611-4 Issued in MN
Practice address
4692 Fable Hill Pkwy N
Hugo, MN 55038-3304
Phone
(651) 605-1182
NPI assigned
Jun 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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 R 174611-4 MN Primary

Addresses

Primary practice location

4692 Fable Hill Pkwy N
Hugo, MN 55038-3304

Mailing address

4692 Fable Hill Pkwy N
Hugo, MN 55038-3304
Phone (651) 605-1182

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121207000156 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698927168 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R 174611-4MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2024 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2019 Accepting new patients

Locations

8650 Hudson Blvd N
Lake Elmo, MN 55042
Phone (651) 561-5651

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

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

310 Smith Ave N
Ste 100
Saint Paul, MN 55102
Phone (651) 251-5500

400 10th St E
Waconia, MN 55387

Organizations & group practices 2

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": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1659634855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4692 FABLE HILL PKWY N",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "550383304",
            "telephone_number": "651-605-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4692 FABLE HILL PKWY N",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "550383304",
            "telephone_number": "651-605-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENNE",
        "first_name": "KATHRYN",
        "middle_name": "SHEEHAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-21",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R 174611-4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hugo, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.