Mark Wayne Jackson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

9250 Issued in TN

Practice address

1901 Clinch Ave
Knoxville, TN 37916-2307

Phone

(865) 331-1111

NPI assigned

Apr 23, 2007

Last updated

Jan 6, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, KY, AL, WI, TX, NM, VA7 enrollments

Enrollment records 7

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth Health Corporation, Inc.Group PAC ID 5496667628, 268 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Medical Center (Bowling Green) Hospital, Bowling Green, KY, CCN 180013

Merit-based Incentive Payment System (MIPS)

Final score

65.57 of 100Reported as group

Quality

59.49

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Commonwealth Health Corporation, Inc

  dba Med Center Health Neurology

  • Neurology Physician
  • Bowling Green, KY
  • NPI 1881109304
  Medicare reassignment Care Compare group NPD
• American Anesthesiology of Tennessee, P.C.

  • Anesthesiology Physician
  • Knoxville, TN
  • NPI 1609822998
  Medicare reassignment NPD
• Lifelinc Anesthesia II, PLLC

  • Anesthesiology Physician
  • Springfield, TN
  • NPI 1821397233

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Lifelinc Anesthesia VIII PLLC

  • Anesthesiology Physician
  • Newport, TN
  • NPI 1679265052

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Northstar Anesthesia II PA

  • Anesthesiology Physician
  • Burleson, TX
  • NPI 1477066405

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Northstar Anesthesia III PA

  • Anesthesiology Physician
  • Corpus Christi, TX
  • NPI 1356968952

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Northstar Anesthesia of Kentucky, PLLC

  • Anesthesiology Physician
  • Louisville, KY
  • NPI 1386938900

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Northstar Anesthesia, PA

  • Anesthesiology Physician
  • Arlington, TX
  • NPI 1912978610

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Physynergy, LLC

  • Anesthesiology Physician
  • Huntsville, AL
  • NPI 1134465560

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Professional Anesthesia Services of Kentucky PLLC

  • Anesthesiology Physician
  • Louisville, KY
  • NPI 1992212807

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Racine Anesthesia Services, LLC

  • Anesthesiology Physician
  • Mount Pleasant, WI
  • NPI 1467782748

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• SMG Anesthesia Specialists LLC

  • Anesthesiology Physician
  • Virginia Beach, VA
  • NPI 1518205004
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bowling Green-Warren County Community Hospital Corporation

  dba The Medical Center

  • General Acute Care Hospital
  • Bowling Green, KY
  • NPI 1043293608
  Care Compare affiliation

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1043438443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 S SERVICE RD STE 350",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 CLINCH AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162307",
            "telephone_number": "865-331-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARK",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1123A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "9250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylee O'Dell Jackson, MS, CCC-SLP
• Kristie A Jackson, DNP APRN AGCNS-BC
• Kyla Christine Jackson
• Lisa Moore Jackson
• Mark W Jackson, MD
• Nanci Elizabeth Jackson, RN,MSN,CPNP
• Natashia Jackson, FNP
• Octavia Laniece Jackson, CCMA
• Rachel Savage Jackson, CRNA
• Rebecca Jackson, RN

• Certified Registered Nurse Anesthetist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.