Jacob Bradley Stay, APRN, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

347 Issued in MN

Practice address

1300 Anne St NW
Bemidji, MN 56601-5103

Phone

(218) 333-5000

NPI assigned

Dec 25, 2011

Last updated

Mar 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Sanford Health of Northern MinnesotaGroup PAC ID 5597725168, 349 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Bemidji Medical Center Hospital, Bemidji, MN, CCN 240100

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Sanford Health of Northern Minnesota

  dba Sanford Health Kelliher Clinic

  • Family Medicine Physician
  • Kelliher, MN
  • NPI 1770849697
  Medicare reassignment Care Compare group NPD
• The Duluth Clinic LTD

  dba Essentia Health Cloquet Clinic

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment Care Compare group NPD
• Deer River Healthcare Center, Inc.

  dba Essentia Health Deer River

  • Critical Access Hospital
  • Deer River, MN
  • NPI 1225049018
  Medicare reassignment
• Sanford Health of Northern Minnesota

  dba Joe Lueken Cancer Center

  • Internal Medicine Physician
  • Bemidji, MN
  • NPI 1780628149
  NPD
• Sanford Health of Northern Minnesota

  dba Sanford Bagley Medical Center

  • Critical Access Hospital
  • Bagley, MN
  • NPI 1932472255
  NPD
• The Duluth Clinic LTD

  dba Essentia Health Wellness Clinic Hermantown

  • Multi-Specialty Clinic/Center
  • Hermantown, MN
  • NPI 1003478892
  NPD
• The Duluth Clinic, LTD.

  dba Essentia Health Hinckley Pharmacy

  • Community/Retail Pharmacy
  • Hinckley, MN
  • NPI 1245081066
  NPD

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

• Sanford Health of Northern Minnesota

  dba Joe Lueken Cancer Center

  • Internal Medicine Physician
  • Bemidji, MN
  • NPI 1780628149

  Hospital

  Care Compare affiliation
• Sanford Health of Northern Minnesota

  dba Sanford Bemidji Medical Center

  • Rural Acute Care Hospital
  • Bemidji, MN
  • NPI 1801870191
  Care Compare affiliation

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

{
    "created_epoch": "1324771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1801165592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ANNE ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015103",
            "telephone_number": "218-333-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 10th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Deer River",
            "state": "MN",
            "postal_code": "566368795",
            "country_code": "US",
            "telephone_number": "218-246-2900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10375 E Movil Lake Rd NE",
            "address_purpose": "LOCATION",
            "city": "Bemidji",
            "state": "MN",
            "postal_code": "566019786",
            "country_code": "US",
            "telephone_number": "218-766-4794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAY",
        "first_name": "JACOB",
        "middle_name": "BRADLEY",
        "credential": "APRN, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-25",
        "last_updated": "2023-03-14",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R190783-0",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jstay2884338@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "1300 Anne St NW",
            "city": "Bemidji",
            "state": "MN",
            "country_code": "US",
            "postal_code": "566015103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jerrod Douglas Spring, MD
• State of Minnesota - Minnesota Management and Budget (Minnesota Veterans Homes Dental Clinic)
• State of Minnesota-Minnesota Management and Budget (Minnesota Veterans Home - Bemidji)
• Michelle M Stately, CHW
• Maria K Statton, MD
• Jessica Lynn Stay, MD
• Isaac Thuan Stearns, LPCC, LADC
• Jayce Roberts Steele
• Nicole Stehly, DPT
• Deborah Steinbar, PA-C

• Certified Registered Nurse Anesthetist in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Certified Registered Nurse Anesthetist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.