Active NPI
Joseph Samuel Wilson, CRNA
- Certified Registered Nurse Anesthetist
- Saint Paul, MN
National Provider Identifier
1962987719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2256
- Practice address
- 640 Jackson St
Saint Paul, MN 55101-2595 - Phone
- (651) 254-3456
- NPI assigned
- Sep 27, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1651348 | MN | |
| Certified Registered Nurse Anesthetist | 367500000X | 2256 | MN | Primary |
Addresses
Primary practice location
640 Jackson St
Saint Paul, MN 55101-2595
Mailing address
8170 33Rd Ave S
Mailstop 21110Q
Bloomington, MN 55425-4516
Phone (952) 883-6000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-2164
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2256 | MN | MD | Nurse Practitioner |
| 1651348 | MN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regions Hospital | Current | Accepting new patients | |
| Regions Hospital | Current | Accepting new patients | |
| Regions Hospital | Current | Accepting new patients |
Locations
640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Saint Paul, MN
- NPI 1154359917
-
- General Acute Care Hospital
- Woodbury, MN
- NPI 1104681105
-
- Rehabilitation Clinic/Center
- Saint Paul, MN
- NPI 1134157092
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Woodbury, MN
- NPI 1104681105
-
- General Acute Care Hospital
- Saint Paul, MN
- NPI 1306873872
-
- General Acute Care Hospital
- Saint Paul, MN
- NPI 1629006457
-
- General Acute Care Hospital
- Stillwater, MN
- NPI 1679391122
-
- General Acute Care Hospital
- Coon Rapids, MN
- NPI 1962149419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789603200000",
"number": "1962987719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE S",
"address_2": "MAILSTOP 21110Q",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554254516",
"telephone_number": "952-883-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 JACKSON ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551012595",
"telephone_number": "651-254-3456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JOSEPH",
"middle_name": "SAMUEL",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-27",
"last_updated": "2026-09-17",
"certification_date": "2026-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MN",
"license": "1651348",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "2256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; 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.