Individual provider Active NPI

Cody W Bekkerus

  • Certified Registered Nurse Anesthetist
  • West Fargo, ND
National Provider Identifier
1740968759
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CR001195 Issued in SD
Practice address
1743 Huntington CT
West Fargo, ND 58078-4302
Phone
(701) 388-5142
NPI assigned
Jul 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X CR001195 SD Primary
Registered Nurse 163W00000X R45055 ND

Addresses

Primary practice location

1743 Huntington CT
West Fargo, ND 58078-4302

Mailing address

126239 N Bridge Rd
Aberdeen, SD 57401-8686
Phone (701) 388-5142

Other practice location 1

305 S State St
Aberdeen, SD 57401-4527
Phone (605) 622-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241104002782 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 0143753780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera St LukesGroup PAC ID 6406764927, 164 clinicians

Practice addresses (Care Compare)

305 S State St
Aberdeen, SD 57401-4527
Phone (605) 622-5100

Hospital & facility affiliations

  • Avera St Lukes Hospital, Aberdeen, SD, CCN 430014
  • Marshall County Healthcare Center - Cah Hospital, Britton, SD, CCN 431312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R45055NDMDRegistered Nurse
CR001195SDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St. Luke'S Current Accepting new patients
Avera St Lukes CurrentSince Oct 23, 2024 Accepting new patients
Avera St. Lukes CurrentSince Oct 23, 2024 Accepting new patients

Locations

305 S State St
Aberdeen, SD 57401
Phone (605) 229-3000

Organizations & group practices 3

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": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1740968759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126239 N BRIDGE RD",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574018686",
            "telephone_number": "701-388-5142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1743 HUNTINGTON CT",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580784302",
            "telephone_number": "701-388-5142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 S State St",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "SD",
            "postal_code": "574014527",
            "country_code": "US",
            "telephone_number": "605-622-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEKKERUS",
        "first_name": "CODY",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SD",
            "license": "CR001195",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R45055",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.