Organization Active NPI

Siesta Anesthesia Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Bismarck, ND
National Provider Identifier
1861034662
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SIESTA ANESTHESIA SERVICES
Doing business as
Journey To Wellness
Practice address
1120 College Dr Ste 100
Bismarck, ND 58501-1225
Phone
(701) 760-8606
Fax
(701) 760-8050
NPI assigned
Oct 13, 2019
Organization subpart
Yes
Parent organization
SIESTA ANESTHESIA SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
Jacqueline M MateriNPI 1881088383
Title
Crna President
Phone
(701) 471-0081

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1120 College Dr Ste 100
Bismarck, ND 58501-1225

Mailing address

1120 College Dr Ste 100
Bismarck, ND 58501-1225
Phone (701) 471-0081

Other names 1

  • Journey To Wellness Doing business as

National Provider Directory

National Provider Directory
Part of
Siesta Anesthesia Services

Locations

1120 College Dr
Ste 100
Bismarck, ND 58501
Phone (701) 699-4052

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1570924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1861034662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 COLLEGE DR STE 100",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011225",
            "telephone_number": "701-471-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 COLLEGE DR STE 100",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011225",
            "telephone_number": "701-760-8606",
            "fax_number": "701-760-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIESTA ANESTHESIA SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SIESTA ANESTHESIA SERVICES",
        "enumeration_date": "2019-10-13",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "MATERI",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CRNA PRESIDENT",
        "authorized_official_telephone_number": "701-471-0081"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Journey To Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Journey To Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; 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.