NPIMap

Individual provider Active NPI

Kathryn Freeman Welles, APRN, CRNA

  • Certified Registered Nurse Anesthetist
  • Duluth, MN
National Provider Identifier
1912457110
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA 1969 Issued in MN
Practice address
915 E 1St St
Duluth, MN 55805-2107
Phone
(218) 249-5555
NPI assigned
Oct 12, 2016
Last updated
Dec 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R200037-0 MN
Certified Registered Nurse Anesthetist 367500000X CRNA 1969 MN Primary

Addresses

Primary practice location

915 E 1St St
Duluth, MN 55805-2107

Mailing address

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5555

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170118000073 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365724853 Reassigns benefits to 7 organizations
I20200710002756 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365724853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke's Hospital of DuluthGroup PAC ID 7113834839, shared by 9 NPIs, 409 clinicians

Practice addresses (Care Compare)

109 N 28TH St E
Superior, WI 54880-6548
Phone (715) 395-3990

512 Skyline Blvd
Cloquet, MN 55720-3787
Phone (218) 879-4641

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1969MNMDPhysician Assistant
CRNA 1969MNMDCertified Registered Nurse Anesthetist
R200037-0MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth Nurse Anesthetist, Certified Registered CurrentSince May 1, 2020 Accepting new patients
Community Memorial Hospital Association CurrentSince Jun 1, 2024 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince May 7, 2018 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince May 7, 2018 Accepting new patients
Ely-Bloomenson Community Hospital Current Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
North Shore Anesthesia P.a Nurse Anesthetist, Certified Registered CurrentSince May 10, 2024 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

512 Skyline Blvd
Cloquet, MN 55720
Phone (218) 878-7207

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

1420 London Rd
Ste 100
Duluth, MN 55805
Phone (218) 728-0650

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

328 W Conan St
Ely, MN 55731
Phone (218) 365-3271

4791 County Road 10
Moose Lake, MN 55767
Phone (218) 249-5357

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

325 11th Ave
Two Harbors, MN 55616
Phone (218) 834-5520

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

Interoperability endpoints

  • Direct secure messaging: him@slk.direct.slhduluth.com
  • Direct secure messaging: kathryn.welles.kfwl01@slk.direct.slhduluth.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1912457110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052107",
            "telephone_number": "218-249-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052107",
            "telephone_number": "218-249-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLES",
        "first_name": "KATHRYN",
        "middle_name": "FREEMAN",
        "credential": "APRN, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R200037-0",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "CRNA 1969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "915 E 1st St",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558052107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.