Individual provider Active NPI

Brian Keith Stank

  • Certified Registered Nurse Anesthetist
  • Duluth, MN
National Provider Identifier
1982762118
Registry record updated Jun 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R1302587 Issued in MN
Practice address
400 E 3Rd St
Duluth, MN 55805-1951
Phone
(218) 786-4626
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2011

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 R1302587 MN Primary

Addresses

Primary practice location

400 E 3Rd St
Duluth, MN 55805-1951

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-4626

Other identifiers 1

IdentifierTypeStateIssuer
470650100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100714000695 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305888595 Reassigns benefits to 1 organization
I20120117000721 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305888595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, shared by 25 NPIs, 1,135 clinicians

Practice addresses (Care Compare)

1101 9TH St N
Virginia, MN 55792-2329
Phone (218) 741-0150

3500 Tower Ave
Superior, WI 54880-5335
Phone (715) 395-5454

502 E 2ND St
Duluth, MN 55805-1913
Phone (218) 786-8364

530 E 2ND St
Duluth, MN 55805-1913
Phone (218) 786-8364

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic LTD Current Accepting new patients
The Duluth Clinic, LTD Nurse Anesthetist, Certified Registered CurrentSince Jun 21, 2010 Accepting new patients
The Duluth Clinic, LTD Nurse Anesthetist, Certified Registered CurrentSince Jul 31, 2003 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Jul 31, 2003 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

1101 9th St N
Virginia, MN 55792
Phone (218) 305-0000

3500 Tower Ave
Ste 1
Superior, WI 54880
Phone (715) 395-5457

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 5

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 2

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309132800000",
    "number": "1982762118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANK",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2011-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R1302587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470650100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "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 Jun 27, 2011; 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.