Active NPI
Marc Richard Smith
- Certified Registered Nurse Anesthetist
- Duluth, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R141080-6
- Practice address
- 400 E 3Rd St
Duluth, MN 55805-1951 - Phone
- (218) 786-4150
- NPI assigned
- Nov 28, 2006
- Last updated
- Jun 27, 2011
- 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 | R141080-6 | MN | Primary |
Addresses
Primary practice location
400 E 3Rd St
Duluth, MN 55805-1951
Mailing address
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-4150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 984246200 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
4572 County Rd
Suite 61
Moose Lake, MN 55767-9401
Phone (218) 485-4481
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R141080-6 | MN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Essentia Health Moose Lake | Current | Accepting new patients | |
| Essentia Health Moose Lake | Current | Accepting new patients | |
| The Duluth Clinic, LTD | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| The Duluth Clinic LTD | Current | Accepting new patients | |
| Moose Lake Community Hospital District | Current | Accepting new patients |
Locations
5211 Highway 110
Aurora, MN 55705
Phone (218) 229-1010
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481
14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779
1101 9th St N
Virginia, MN 55792
Phone (218) 305-0000
3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281
3500 Tower Ave
Ste 1
Superior, WI 54880
Phone (715) 395-5457
Organizations & group practices 5
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.
-
- Critical Access Hospital
- Moose Lake, MN
- NPI 1154959880
-
dba Essentia Health Cloquet Clinic
- Multi-Specialty Clinic/Center
- Cloquet, MN
- NPI 1902563638
-
dba Essentia Health Moose Lake Clinic
- Critical Access Hospital Clinic/Center
- Moose Lake, MN
- NPI 1275102048
-
dba Mercy Hospital
- Critical Access Hospital
- Moose Lake, MN
- NPI 1942398029
-
dba Duluth Clinic
- Anesthesiology Physician
- Duluth, MN
- NPI 1760417935
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Moose Lake, MN
- NPI 1154959880
-
dba Essentia Health Moose Lake Clinic
- Critical Access Hospital Clinic/Center
- Moose Lake, MN
- NPI 1275102048
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309132800000",
"number": "1730256785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 E 3RD ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558051951",
"telephone_number": "218-786-4150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 E 3RD ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558051951",
"telephone_number": "218-786-4150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "MARC",
"middle_name": "RICHARD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2011-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "R141080-6",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "984246200",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; 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.