Individual provider Active NPI

Ryan Winder Nordgren, CRNA

  • Certified Registered Nurse Anesthetist
  • Clovis, NM
National Provider Identifier
1710224167
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN619284 Issued in PA
Practice address
2200 W 21St St
Clovis, NM 88101-2011
Phone
(801) 633-4702
NPI assigned
Jan 4, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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 RN619284 PA Primary

Addresses

Primary practice location

2200 W 21St St
Clovis, NM 88101-2011

Mailing address

1017 Chase MDWS
Clovis, NM 88101-2930
Phone (801) 633-4702

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160301002063 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840445078 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sleepy Plains Anesthesia LLCGroup PAC ID 4284960352, 9 clinicians

Practice addresses (Care Compare)

42121 US Hwy 70
Portales, NM 88130-9054
Phone (575) 359-1800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of New Mexico P C CurrentSince Feb 1, 2016 Accepting new patients
Sleepy Plains Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2019 Accepting new patients

Locations

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

2100 N Mlk Blvd
Clovis, NM 88101
Phone (505) 769-2141

42121 US Highway 70
Portales, NM 88130
Phone (505) 226-3627

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1710224167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 CHASE MDWS",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881012930",
            "telephone_number": "801-633-4702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W 21ST ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881012011",
            "telephone_number": "801-633-4702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDGREN",
        "first_name": "RYAN",
        "middle_name": "WINDER",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-04",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN619284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.