Individual provider Active NPI

Jody L Kleyman, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Plymouth, MN
National Provider Identifier
1972582823
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
486 Issued in MN
Practice address
2855 Campus Dr
Plymouth, MN 55441
Phone
(763) 577-7240
NPI assigned
Jan 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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 486 MN Primary

Addresses

Primary practice location

2855 Campus Dr
Plymouth, MN 55441

Mailing address

6465 Wayzata Blvd
Ste 315
St Louis Park, MN 55426-1728

Other practice location 1

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-5222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040719001322 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1759360092 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet Methodist HospitalGroup PAC ID 7315840063, 112 clinicians
Metropolitan Anesthesia Network LLPGroup PAC ID 5698689123, 516 clinicians

Practice addresses (Care Compare)

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-5000

800 E 28TH St
Minneapolis, MN 55407-3723
Phone (612) 863-5370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Ambulatory Services LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 4, 2024 Accepting new patients
Park Nicollet Methodist Hospital Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2006 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Feb 3, 2020 Accepting new patients
Anesthesiology, P.a. Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2019 Accepting new patients
Mngi Digestive Health, P.a. CurrentSince Apr 2, 2018 Accepting new patients
Park Nicollet Methodist Hospital CurrentSince Jul 1, 2006 Accepting new patients

Locations

5705 W Old Shakopee Rd
Ste 150
Bloomington, MN 55437
Phone (612) 870-5530

9145 Springbrook Dr NW
Ste 200
Coon Rapids, MN 55433
Phone (612) 625-8999

1185 Town Centre Dr
Eagan, MN 55123
Phone 61243539602820

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

3001 Broadway St NE
Ste 500
Minneapolis, MN 55413
Phone (612) 870-5557

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

8100 W 78th St
Ste 220
Minneapolis, MN 55439
Phone (952) 914-8400

2855 Campus Dr
Plymouth, MN 55441
Phone (763) 577-7000

15700 37th Ave N
Ste 300
Plymouth, MN 55446
Phone (612) 870-5555

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

2855 Campus Dr
Ste 200
Plymouth, MN 55441
Phone (763) 302-2800

15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

1700 Saint Francis Ave
Ste 100
Shakopee, MN 55379
Phone (952) 993-7800

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1972582823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 WAYZATA BLVD",
            "address_2": "STE 315",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 CAMPUS DR",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55441",
            "telephone_number": "763-577-7240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6500 Excelsior Blvd",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554264702",
            "country_code": "US",
            "telephone_number": "952-993-5222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEYMAN",
        "first_name": "JODY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.