Individual provider Active NPI

Robin R Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • Coon Rapids, MN
National Provider Identifier
1760474829
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R 135898-4 Issued in MN
Practice address
8990 Springbrook Dr NW
Ste 250
Coon Rapids, MN 55433-5850
Phone
(763) 398-0099
Fax
(763) 398-0124
NPI assigned
Aug 16, 2005
Last updated
May 16, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2008

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 R 135898-4 MN Primary

Addresses

Primary practice location

8990 Springbrook Dr NW
Ste 250
Coon Rapids, MN 55433-5850

Mailing address

15824 Dry Meadow LN
Apple Valley, MN 55124-6997

Other identifiers 2

IdentifierTypeStateIssuer
414234900MedicaidMN
997N0JOOtherMNBCBSMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050421000300 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8426096330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Metropolitan Anesthesia PAGroup PAC ID 1153370911, 25 clinicians

Practice addresses (Care Compare)

201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (952) 892-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R 135898-4MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
South Metropolitan Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2005 Accepting new patients

Locations

14101 Fairview Dr
Burnsville, MN 55337
Phone (612) 672-5346

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

400 10th St E
Waconia, MN 55387

Organizations & group practices 1

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210896000000",
    "number": "1760474829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15824 DRY MEADOW LN",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8990 SPRINGBROOK DR NW",
            "address_2": "STE 250",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335850",
            "telephone_number": "763-398-0099",
            "fax_number": "763-398-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROBIN",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2008-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R 135898-4",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "414234900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMN",
            "identifier": "997N0JO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.