Individual provider Active NPI

Jacqueline Marie Klinkner, CRNA

  • Certified Registered Nurse Anesthetist
  • Edina, MN
National Provider Identifier
1659882322
Registry record updated Dec 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
23802 Issued in TN
Practice address
6401 France Ave S
Edina, MN 55435-2104
Phone
(952) 924-5000
NPI assigned
Oct 20, 2017
Last updated
Dec 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 23802 TN Primary
Registered Nurse 163W00000X 225115 TN

Addresses

Primary practice location

6401 France Ave S
Edina, MN 55435-2104

Mailing address

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181228001377 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062775422 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan Anesthesia Network LLPGroup PAC ID 5698689123, 516 clinicians
Southdale Anesthesiologists LLCGroup PAC ID 6709842461, 62 clinicians

Practice addresses (Care Compare)

6099 Wayzata Blvd
Suite 300
St Louis Park, MN 55416-5538
Phone (612) 832-9360

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
225115TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southdale Anesthesiologists, LLC CurrentSince Jun 15, 2020 Accepting new patients
St. Francis Regional Medical Center CurrentSince May 1, 2023 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince May 15, 2022 Accepting new patients
South Metropolitan Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2019 Accepting new patients
University Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2019 Accepting new patients
Certified Anesthesia Care, Co. Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2019 Accepting new patients
St Francis Regional Medical Center Nurse Anesthetist, Certified Registered CurrentSince May 1, 2023 Accepting new patients
Central Minnesota Anesthesia Providers, PA Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2019 Accepting new patients

Locations

14054 Bank St
Becker, MN 55308
Phone (763) 260-8808

9801 DuPont Ave S
Ste 100
Bloomington, MN 55431

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

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

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

7400 France Ave S
Ste 100
Minneapolis, MN 55435
Phone (612) 597-6316

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

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200

6099 Wayzata Blvd
Ste 300
St Louis Park, MN 55416
Phone (612) 832-9360

400 10th St E
Waconia, MN 55387

Interoperability endpoints

  • Direct secure messaging: jacqueline.klinkner.p21@direct.painphysicians.nextgenshare.com

Organizations & group practices 8

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": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1659882322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 FRANCE AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352104",
            "telephone_number": "952-924-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 FRANCE AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352104",
            "telephone_number": "952-924-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINKNER",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-20",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "23802",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "225115",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; 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.