Jesyca R Haines, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

D163533 Issued in IA

Practice address

1601 Sioux Valley Dr
Luverne, MN 56156-4500

Phone

(507) 283-4476

NPI assigned

May 21, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in SD, IA, MN3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Health NetworkGroup PAC ID 6800707100, 357 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

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 and National Provider Directory roles.

• Sanford Health Network

  • Critical Access Hospital
  • Luverne, MN
  • NPI 1497703045

  MN

  Medicare reassignment NPD
• Sanford Health Network

  • Family Medicine Physician
  • Tracy, MN
  • NPI 1699869875

  MN

  Medicare reassignment NPD
• Crawford County Memorial Hospital

  • Critical Access Hospital
  • Denison, IA
  • NPI 1578555116

  IA

  Medicare reassignment NPD
• Fisher Medical Consulting PC

  • Pain Medicine (Anesthesiology) Physician
  • Dakota Dunes, SD
  • NPI 1790378883

  SD

  Medicare reassignment NPD
• Sanford Health Network

  • Family Medicine Physician
  • Luverne, MN
  • NPI 1174554760
  NPD
• Sanford Health Network

  • Rural Health Clinic/Center
  • Mountain Lake, MN
  • NPI 1568469039
  NPD

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1902166259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SIOUX VALLEY DR",
            "city": "LUVERNE",
            "state": "MN",
            "postal_code": "561564500",
            "telephone_number": "507-283-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAINES",
        "first_name": "JESYCA",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SD",
            "license": "CR000789",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D163533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46022474348",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS SD",
            "identifier": "1902166259",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902166259",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01103855",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MN",
            "identifier": "1902166259",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "1902166259",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902166259",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Gehrke, LMFT
• Trisha Goembel, CNP
• Larry Green, LP
• Tia Rae Hadler
• Kyle D Hailey, AAS
• Briana Halse, LPC-MH, LPC, RPT-S
• Patricia Ann Halse
• Hawkeye Clinic of Luverne, PC
• Healing Path Counseling & Wellness, P.L.L.C.
• Jennifer Lynn Hoefert, DPT

• All providers in Luverne, MN
• Certified Registered Nurse Anesthetist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; 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.