Individual provider Active NPI

Mark Lathrop, CRNA

  • Certified Registered Nurse Anesthetist
  • Jacksonville, FL
National Provider Identifier
1003598368
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
148709 Issued in FL
Practice address
2449 Blackbeard Dr
Jacksonville, FL 32224-1139
Phone
(904) 238-0070
NPI assigned
Aug 4, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9415770 FL
Nurse Practitioner 363L00000X APRN11032408 FL
Certified Registered Nurse Anesthetist 367500000X 148709 FL Primary

Addresses

Primary practice location

2449 Blackbeard Dr
Jacksonville, FL 32224-1139

Mailing address

2449 Blackbeard Dr
Jacksonville, FL 32224-1139
Phone (904) 238-0070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240521001888 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456793553 Reassigns benefits to 1 organization
I20250409003095 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456793553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

509 Biltmore Ave
Asheville, NC 28801-4601
Phone (828) 213-2325

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9415770FLMDRegistered Nurse
APRN11032408FLMDNurse Practitioner
148709FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Apr 22, 2024 Accepting new patients
Mission Community Anesthesiology Specialists LLC CurrentSince Apr 1, 2025 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Apr 22, 2024 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
Mission Health Community Multispecialty Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2025 Accepting new patients

Locations

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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 1

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": "1691107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1003598368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2449 BLACKBEARD DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241139",
            "telephone_number": "904-238-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2449 BLACKBEARD DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241139",
            "telephone_number": "904-238-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHROP",
        "first_name": "MARK",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-04",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9415770",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11032408",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "148709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.