Individual provider Active NPI

Christian Jackson, CRNA

  • Certified Registered Nurse Anesthetist
  • Independence, MO
National Provider Identifier
1063466951
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2001004399 Issued in MO
Practice address
19600 E 39TH St S
Independence, MO 64057-2301
Phone
(913) 428-2900
Fax
(913) 428-2951
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2001004399 MO Primary

Addresses

Primary practice location

19600 E 39TH St S
Independence, MO 64057-2301

Mailing address

8717 W 110TH St Ste 600
Overland Park, KS 66210-2126
Phone (913) 428-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050719001295 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688601883 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes East Anesthesia Services PCGroup PAC ID 1850333477, 44 clinicians
Anesthesia Associates of Kansas City PAGroup PAC ID 1951206168, 214 clinicians

Practice addresses (Care Compare)

100 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000
Phone (816) 347-5097

19600 E 39TH St
Centerpoint Medical Center
Independence, MO 64057-2301
Phone (816) 698-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2001004399MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Kansas City PA CurrentSince Jan 3, 2017 Accepting new patients
St Lukes East Anesthesia Services,P.C. CurrentSince Sep 1, 2022 Accepting new patients
Westport Anesthesia Services of Missouri, PC Past Accepting new patients
Westport Anesthesia Services of Kansas PA Past Accepting new patients
Anesthesia Consulting Services, PA Past Accepting new patients
Westglen Endoscopy Center LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Westglen Endoscopy Center LLC Past Accepting new patients

Locations

8935 State Ave
Kansas City, KS 66112
Phone (816) 389-6030

8717 W 110th St
Ste 600
Overland Park, KS 66210
Phone (913) 428-2910

19600 E 39th St S
Independence, MO 64057
Phone (816) 698-7000

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

120 NE Saint Lukes Blvd
Lees Summit, MO 64086
Phone (816) 347-5800

100 NE Saint Lukes Blvd
Lees Summit, MO 64086
Phone (816) 347-5097

Interoperability endpoints

  • Direct secure messaging: cjackson11371@direct.saint-lukes.org

Organizations & group practices 8

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1063466951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8717 W 110TH ST STE 600",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102126",
            "telephone_number": "913-428-2900",
            "fax_number": "913-428-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19600 E 39TH ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572301",
            "telephone_number": "913-428-2900",
            "fax_number": "913-428-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHRISTIAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2001004399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.

Verify at the official NPI Registry.