Active NPI
Kristi Jo Johnson, CRNA
- Certified Registered Nurse Anesthetist
- Fargo, ND
National Provider Identifier
1770501322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R22652
- Practice address
- 3280 20TH St S
Fargo, ND 58104-5917 - Phone
- (701) 293-7408
- NPI assigned
- Jul 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | R22652 | ND | Primary |
Addresses
Primary practice location
3280 20TH St S
Fargo, ND 58104-5917
Mailing address
4307 Riverwood Dr N
Fargo, ND 58102-5324
Phone (701) 361-4146
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R22652 | ND | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Plains Anesthesia, PLLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Valley Anesthesia Associates PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Red River Anesthesia P C | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
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.
-
- Anesthesiology Physician
- Fargo, ND
- NPI 1114479375
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Fargo, ND
- NPI 1467513176
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Breckenridge, MN
- NPI 1295842623
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770501322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4307 RIVERWOOD DR N",
"city": "FARGO",
"state": "ND",
"postal_code": "581025324",
"telephone_number": "701-361-4146",
"fax_number": "701-239-1779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3280 20TH ST S",
"city": "FARGO",
"state": "ND",
"postal_code": "581045917",
"telephone_number": "701-293-7408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KRISTI",
"middle_name": "JO",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "ND",
"license": "R22652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.