NPIMap

Individual provider Active NPI

Kimberly M Dylla, CRNA

  • Certified Registered Nurse Anesthetist
  • Brainerd, MN
National Provider Identifier
1730262098
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA419 Issued in MN
Practice address
523 N 3Rd St
Brainerd, MN 56401-3054
Phone
(218) 829-2861
NPI assigned
Oct 23, 2006
Last updated
May 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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 CRNA419 MN Primary

Addresses

Primary practice location

523 N 3Rd St
Brainerd, MN 56401-3054

Mailing address

1702 University Dr S
Fargo, ND 58103-4940
Phone (701) 364-4222

Other names 1

  • Kimberly Gaard Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061110000053 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173521903 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regions HospitalGroup PAC ID 3173436755, 215 clinicians
St Josephs Medical CenterGroup PAC ID 8224948443, 238 clinicians

Practice addresses (Care Compare)

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7700

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-8080

523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 829-2861

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-2164

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CRNA419MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Regions Hospital CurrentSince Sep 27, 2006 Accepting new patients
Regions Hospital CurrentSince Sep 27, 2006 Accepting new patients
Allina Health System Current Accepting new patients
St. Joseph's Medical Center CurrentSince Jun 11, 2018 Accepting new patients
St Joseph's Medical Center CurrentSince Jun 11, 2018 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2023 Accepting new patients
St. Joseph's Medical Center Current Accepting new patients
Allina Health System Nurse Anesthetist, Certified Registered CurrentSince Jan 27, 2025 Accepting new patients
Brainerd Lakes Surgery Center L L C CurrentSince Jun 4, 2018 Accepting new patients
Regina Medical Center Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

13114 Isle Dr
Baxter, MN 56425
Phone (218) 822-2400

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

1175 Nininger Rd
Hastings, MN 55033
Phone (651) 404-1000

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

Organizations & group practices 11

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1730262098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940",
            "telephone_number": "701-364-4222",
            "fax_number": "952-883-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 N 3RD ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013054",
            "telephone_number": "218-829-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYLLA",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "CRNA419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "GAARD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brainerd, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; 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.