Individual provider Active NPI

Amy Beth Tevis, CRNA

  • Certified Registered Nurse Anesthetist
  • Winona, MN
National Provider Identifier
1851801203
Registry record updated Oct 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
118457 Issued in WI
Practice address
855 Mankato Ave
Winona, MN 55987-4868
Phone
(800) 944-3960
NPI assigned
Oct 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2017

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 118457 WI Primary

Addresses

Primary practice location

855 Mankato Ave
Winona, MN 55987-4868

Mailing address

525 21St Ave S
Onalaska, WI 54650-8751
Phone (608) 385-4192

Other names 1

  • Amy Beth Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171204000486 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456618222 Reassigns benefits to 1 organization
I20230510002878 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456618222 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tomah Memorial Hospital IncGroup PAC ID 6901897016, shared by 4 NPIs, 54 clinicians

Practice addresses (Care Compare)

501 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 372-2181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
118457WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Tomah Memorial Hospital Inc CurrentSince Nov 1, 2025 Accepting new patients
Tomah Memorial Hospital Inc CurrentSince Dec 24, 2022 Accepting new patients
Tomah Memorial Hospital Inc CurrentSince Dec 24, 2022 Accepting new patients
Winona Health Services CurrentSince Nov 6, 2017 Accepting new patients

Locations

855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680

501 Gopher Dr
Tomah, WI 54660
Phone (608) 371-2181

Interoperability endpoints

  • Direct secure messaging: atevis756242@direct.emplifyhealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1851801203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 21ST AVE S",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508751",
            "telephone_number": "608-385-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MANKATO AVE",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559874868",
            "telephone_number": "800-944-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEVIS",
        "first_name": "AMY",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-11",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "118457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "JOHNSON",
            "middle_name": "BETH",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winona, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; 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.