Active NPI
Martin W Coughlin, CRNA
- Certified Registered Nurse Anesthetist
- St Paul, MN
National Provider Identifier
1700850997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R0887281
- Practice address
- 393 Dunlap St
St Paul, MN 55104 - Phone
- (651) 602-7245
- NPI assigned
- Feb 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R0887281 | MN | Primary |
Addresses
Primary practice location
393 Dunlap St
St Paul, MN 55104
Mailing address
2854 Highway 55
Suite 130
Eagan, MN 55121
Phone (651) 224-4930
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 936343200 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346371200000",
"number": "1700850997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2854 HIGHWAY 55",
"address_2": "SUITE 130",
"city": "EAGAN",
"state": "MN",
"postal_code": "55121",
"telephone_number": "651-224-4930",
"fax_number": "651-842-3391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "393 DUNLAP ST",
"city": "ST PAUL",
"state": "MN",
"postal_code": "55104",
"telephone_number": "651-602-7245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COUGHLIN",
"first_name": "MARTIN",
"middle_name": "W",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-14",
"last_updated": "2012-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "R0887281",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "936343200",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.