Active NPI
Jeannine M Henry, CRNA
- Certified Registered Nurse Anesthetist
- St Paul, MN
National Provider Identifier
1811096803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R0839718
- Practice address
- 333 Smith Ave N
St Paul, MN 55102 - Phone
- (651) 735-0501
- Fax
- (651) 735-1870
- NPI assigned
- Sep 22, 2006
- Sex
- Female
- Sole proprietor
- No
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 | R0839718 | MN | Primary |
Addresses
Primary practice location
333 Smith Ave N
St Paul, MN 55102
Mailing address
8681 Eagle Point Blvd
Lake Elmo, MN 55042-8628
Phone (651) 251-8021
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 847343900 | Medicaid | MN |
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 |
|---|---|---|---|
| 137 | MN | MD | Nurse Practitioner |
| R0839718 | MN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mngi Digestive Health, P.a. | Current | Accepting new patients | |
| Associated Anesthesiologists PA | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Mngi Endoscopy ASC Inc | Past | Accepting new patients |
Locations
3001 Broadway St NE
Ste 500
Minneapolis, MN 55413
Phone (612) 870-5557
15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008
333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
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.
-
- Gastroenterology Physician
- Minneapolis, MN
- NPI 1609804541
-
- Anesthesiology Physician
- Lake Elmo, MN
- NPI 1780610139
Nurse Anesthetist, Certified Registered
-
- Ambulatory Surgical Clinic/Center
- Minneapolis, MN
- NPI 1669496345
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286150400000",
"number": "1811096803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8681 EAGLE POINT BLVD",
"city": "LAKE ELMO",
"state": "MN",
"postal_code": "550428628",
"telephone_number": "651-251-8021",
"fax_number": "651-251-8050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 SMITH AVE N",
"city": "ST PAUL",
"state": "MN",
"postal_code": "55102",
"telephone_number": "651-735-0501",
"fax_number": "651-735-1870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRY",
"first_name": "JEANNINE",
"middle_name": "M",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-22",
"last_updated": "2010-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "R0839718",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "847343900",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.