Active NPI
Coltyn Tyler Johnson, APRN, CRNA
- Certified Registered Nurse Anesthetist
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 10045538
- Practice address
- 2525 Chicago Ave
Minneapolis, MN 55404-4518 - Phone
- (612) 813-6000
- NPI assigned
- Sep 9, 2020
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 2502 | MN | |
| Certified Registered Nurse Anesthetist | 367500000X | 10045538 | OR | Primary |
Addresses
Primary practice location
2525 Chicago Ave
Minneapolis, MN 55404-4518
Mailing address
500 NE Multnomah St Ste 100
Portland, OR 97232-2031
Phone (800) 813-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, MN
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000
200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
Hospital & facility affiliations
- Mayo Clinic Hospital Rochester
- Kaiser Sunnyside Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2502 | MN | MD | Certified Registered Nurse Anesthetist |
| 10045538 | OR | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients |
Locations
10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
500 NE Multnomah St
Ste 100
Portland, OR 97232
Phone (503) 499-5200
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
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.
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
Nurse Anesthetist, Certified Registered
-
- Multi-Specialty Clinic/Center
- Rochester, MN
- NPI 1922074434
-
- General Practice Physician
- Portland, OR
- NPI 1063990695
-
- Clinic/Center
- Hillsboro, OR
- NPI 1942718622
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Rochester, MN
- NPI 1841266194
-
- General Acute Care Hospital
- Clackamas, OR
- NPI 1124182902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773619200000",
"number": "1992310700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 NE MULTNOMAH ST STE 100",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322031",
"telephone_number": "800-813-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 CHICAGO AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554044518",
"telephone_number": "612-813-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "COLTYN",
"middle_name": "TYLER",
"credential": "APRN, CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-09",
"last_updated": "2026-03-16",
"certification_date": "2026-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "2502",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OR",
"license": "10045538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.