Individual provider Active NPI

Jared Gregg, CRNA

  • Certified Registered Nurse Anesthetist
  • Florence, AL
National Provider Identifier
1003153180
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-167508 Issued in AL
Practice address
205 Marengo St
Florence, AL 35630-6033
Phone
(256) 768-9191
Fax
(256) 768-9775
NPI assigned
Jan 10, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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 4704294701 MI
Certified Registered Nurse Anesthetist 367500000X 1-167508 AL Primary

Addresses

Primary practice location

205 Marengo St
Florence, AL 35630-6033

Mailing address

PO Box 10005
Florence, AL 35631-2005
Phone (256) 768-9191

Other practice location 1

900 Peeler St
Kalamazoo, MI 49008-2300
Phone (269) 345-8618

Other practice location 2

201 Avalon Ave
Muscle Shoals, AL 35661-2805
Phone (256) 386-1600

Other identifiers 1

IdentifierTypeStateIssuer
4704294701OtherMIMICHIGAN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, AL, GA, NM4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20151009001922 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022253590 Reassigns benefits to 1 organization
I20180830002470 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022253590 Reassigns benefits to 1 organization
I20200922001179 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022253590 Reassigns benefits to 1 organization
I20201210001604 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022253590 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Street Anesthesia of New Mexico, LLCGroup PAC ID 3476807538, 228 clinicians

Practice addresses (Care Compare)

2400 Unser Blvd SE
Suite 9100B
Rio Rancho, NM 87124-4740
Phone (720) 245-0321

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
RCHP - Florence LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2018 Accepting new patients
Main Street Anesthesia of New Mexico, LLC CurrentSince Aug 3, 2022 Accepting new patients
Anesthesia Associates of New Mexico P C CurrentSince Feb 1, 2021 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Aug 1, 2020 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 20, 2017 Accepting new patients

Locations

201 Avalon Ave
Muscle Shoals, AL 35661
Phone (256) 386-1600

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

1014 Forsyth St
Macon, GA 31201
Phone (478) 633-5800

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

888 Pine St
Macon, GA 31201
Phone (478) 751-0527

1720 Louisiana Blvd NE
Ste 401
Albuquerque, NM 87110
Phone (505) 260-4300

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

2400 Unser Blvd SE
Ste 9100B
Rio Rancho, NM 87124
Phone (505) 926-1400

117 E 19th St
Roswell, NM 88201
Phone (505) 727-2000

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

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": "1357776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1003153180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10005",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356312005",
            "telephone_number": "256-768-9191",
            "fax_number": "256-768-9775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MARENGO ST",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356306033",
            "telephone_number": "256-768-9191",
            "fax_number": "256-768-9775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Peeler St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490082300",
            "country_code": "US",
            "telephone_number": "269-345-8618",
            "fax_number": "269-345-1508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Avalon Ave",
            "address_purpose": "LOCATION",
            "city": "Muscle Shoals",
            "state": "AL",
            "postal_code": "356612805",
            "country_code": "US",
            "telephone_number": "256-386-1600",
            "fax_number": "256-768-9775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREGG",
        "first_name": "JARED",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-10",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704294701",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-167508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LICENSE",
            "identifier": "4704294701",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.