Individual provider Active NPI

Roger W Meinen, CRNA

  • Certified Registered Nurse Anesthetist
  • Yankton, SD
National Provider Identifier
1780699488
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
021848 Issued in SD
Practice address
2601 Fox Run Pkwy
Yankton, SD 57078-5341
Phone
(605) 664-5050
Fax
(605) 664-5051
NPI assigned
Jul 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R014067 SD
Certified Registered Nurse Anesthetist 367500000X 021848 SD Primary

Addresses

Primary practice location

2601 Fox Run Pkwy
Yankton, SD 57078-5341

Mailing address

307 Walnut St
Suite C
Yankton, SD 57078-4361
Phone (605) 664-5050

Other identifiers 6

IdentifierTypeStateIssuer
020584922MedicaidNE
35254OtherSDMIDLANDS CHOICE
4993763OtherSDBLUE CROSS BLUE SHIELD
5750832MedicaidSD
9220266OtherSDDAKOTACARE
P00435823OtherSDRAILROAD

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
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R014067SDMDRegistered Nurse
021848SDMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1780699488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 WALNUT ST",
            "address_2": "SUITE C",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570784361",
            "telephone_number": "605-664-5050",
            "fax_number": "605-664-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 FOX RUN PKWY",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570785341",
            "telephone_number": "605-664-5050",
            "fax_number": "605-664-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEINEN",
        "first_name": "ROGER",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R014067",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SD",
            "license": "021848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020584922",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "35254",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4993763",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5750832",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "9220266",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00435823",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yankton, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.