Active NPI
Jennifer L Jackson, CRNA
- Certified Registered Nurse Anesthetist
- Chattanooga, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- APN16918
- Practice address
- 2341 McCallie Ave
Suite 402
Chattanooga, TN 37404-3239 - Phone
- (423) 698-3309
- Fax
- (423) 624-6355
- NPI assigned
- Sep 24, 2012
- Sex
- Female
- 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 | APN16918 | TN | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | RN147906 | TN |
Addresses
Primary practice location
2341 McCallie Ave
Suite 402
Chattanooga, TN 37404-3239
Mailing address
PO Box 3549
Chattanooga, TN 37404-0549
Phone (423) 698-3309
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4335469 | Other | TN | BC BS OF TN |
| 1530475 | Medicaid | TN | |
| P01124805 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, GA
Enrollment records 2
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
Practice addresses (Care Compare)
1200 Memorial Dr
Dalton, GA 30720-2529
Phone (706) 272-6000
Hospital & facility affiliations
- Hamilton Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN16918 | TN | MD | Certified Registered Nurse Anesthetist |
| RN147906 | TN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Anesthesiology of Tennessee, P.C. | Current | Accepting new patients | |
| North Georgia Anesthesia Services PC | Current | Accepting new patients | |
| Anesthesiologists Associated PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Anesthesiologists Associated PC | Past | Accepting new patients |
Locations
1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115
2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620
2515 Desales Ave
Chattanooga, TN 37404
Phone (423) 648-6672
2333 McCallie Ave
Chattanooga, TN 37404
Phone (423) 493-1387
9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040
501 20th St
Ste 606
Knoxville, TN 37916
Phone (865) 331-2278
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.
-
- Anesthesiology Physician
- Dalton, GA
- NPI 1114545431
-
- Anesthesiology Physician
- Knoxville, TN
- NPI 1609822998
-
- Certified Registered Nurse Anesthetist
- Chattanooga, TN
- NPI 1043278443
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Chattanooga, TN
- NPI 1518923705
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dalton, GA
- NPI 1528056066
-
- Psychiatric Hospital Unit
- Dalton, GA
- NPI 1760645782
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360195200000",
"number": "1043561608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3549",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374040549",
"telephone_number": "423-698-3309",
"fax_number": "423-624-6355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2341 MCCALLIE AVE",
"address_2": "SUITE 402",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374043239",
"telephone_number": "423-698-3309",
"fax_number": "423-624-6355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JENNIFER",
"middle_name": "L",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-24",
"last_updated": "2013-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "APN16918",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "RN147906",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS OF TN",
"identifier": "4335469",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1530475",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01124805",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.