Individual provider Active NPI

Ann Marie Nelson, CRNA

  • Certified Registered Nurse Anesthetist
  • Willmar, MN
National Provider Identifier
1710983473
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
072637 Issued in MN
Practice address
301 Becker Ave SW
Willmar, MN 56201-3302
Phone
(320) 231-4120
NPI assigned
Jun 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2010

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 072637 MN Primary

Addresses

Primary practice location

301 Becker Ave SW
Willmar, MN 56201-3302

Mailing address

221A Lakeview Dr
Spicer, MN 56288-9622
Phone (320) 894-2817

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050303000294 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911951801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare Clinic Southwest LLCGroup PAC ID 8426457946, 172 clinicians

Practice addresses (Care Compare)

600 Peterson Pkwy
New London, MN 56273-7823
Phone (320) 354-2222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
072637MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Southwest LLC CurrentSince Nov 1, 2021 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Nov 1, 2021 Accepting new patients

Locations

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

301 Becker Ave SW
Willmar, MN 56201
Phone (320) 231-4120

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

Interoperability endpoints

  • Direct secure messaging: anelson29790@direct.centracare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274140800000",
    "number": "1710983473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221A LAKEVIEW DR",
            "city": "SPICER",
            "state": "MN",
            "postal_code": "562889622",
            "telephone_number": "320-894-2817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 BECKER AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013302",
            "telephone_number": "320-231-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2010-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "072637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; 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.