Marc Leslie Engelbrektson, C.R.N.A.

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

036098 Issued in ND

Practice address

2585 23Rd Ave S
Ste a.
Fargo, ND 58103

Phone

(701) 478-4404

Fax

(701) 478-4407

NPI assigned

Mar 28, 2007

Last updated

Apr 9, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Prairie Oral Surgery LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Fargo, ND
  • NPI 1598763120
  NPD (past)
• Prairie Oral Surgery LTD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Detroit Lakes, MN
  • NPI 1912859364
  NPD (past)
• Red River Anesthesia P C

  • Certified Registered Nurse Anesthetist
  • Breckenridge, MN
  • NPI 1295842623

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239235200000",
    "number": "1710006887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 23RD AVE S.",
            "address_2": "STE. A. PRAIRIE ORAL SURGERY",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58103",
            "telephone_number": "701-478-4404",
            "fax_number": "701-478-4407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 23RD AVE S",
            "address_2": "STE A.",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58103",
            "telephone_number": "701-478-4404",
            "fax_number": "701-478-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELBREKTSON",
        "first_name": "MARC",
        "middle_name": "LESLIE",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2009-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "036098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12355",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "488843000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "24266",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leona Ann Engberg, RN
• Emily Engebretson
• Kira Engebretson
• Kylie Engebretson, PA-C
• Gloria M. Engel, PA-C
• Brittney Engelhard, LBSW
• Samantha Engelhard
• Heather England, DPT
• Madalyn Marie England, OTR/L
• Rachel England

• Certified Registered Nurse Anesthetist in Fargo, ND
• Providers in Fargo, ND by specialty
• Certified Registered Nurse Anesthetist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.