Individual provider Active NPI

Katie Jo Witt, CRNA

  • Certified Registered Nurse Anesthetist
  • Minnetonka, MN
National Provider Identifier
1912243734
Registry record updated Dec 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R1465356 Issued in MN
Practice address
13911 Ridgedale Dr
Suite 350
Minnetonka, MN 55305-1771
Phone
(952) 932-9012
Fax
(952) 932-7122
NPI assigned
Dec 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2012

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 R1465356 MN Primary

Addresses

Primary practice location

13911 Ridgedale Dr
Suite 350
Minnetonka, MN 55305-1771

Mailing address

13911 Ridgedale Dr
Suite 350
Minnetonka, MN 55305-1771
Phone (952) 932-9012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130205000136 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901050681 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alomere HealthGroup PAC ID 9931690047, 123 clinicians

Practice addresses (Care Compare)

111 17TH Ave E
Alexandria, MN 56308-5273
Phone (320) 762-1511

Hospital & facility affiliations

  • Alomere Health Hospital, Alexandria, MN, CCN 240030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
628MNMDChiropractor
R1465356MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
West Central Pathology and Laboratory Medicine PA Current Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
Regional Anesthesia Services PA CurrentSince Jan 1, 2013 Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients

Locations

111 17th Ave E
Alexandria, MN 56308
Phone (320) 762-1511

13911 Ridgedale Dr
Ste 404B
Minnetonka, MN 55305
Phone (612) 636-0061

13911 Ridgedale Dr
Ste 350
Minnetonka, MN 55305
Phone (952) 932-0998

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1356480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356480000000",
    "number": "1912243734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13911 RIDGEDALE DR",
            "address_2": "SUITE 350",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051771",
            "telephone_number": "952-932-9012",
            "fax_number": "952-932-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13911 RIDGEDALE DR",
            "address_2": "SUITE 350",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051771",
            "telephone_number": "952-932-9012",
            "fax_number": "952-932-7122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT",
        "first_name": "KATIE",
        "middle_name": "JO",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-26",
        "last_updated": "2012-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R1465356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; 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.