Active NPI
Jacob Johnson, CRNA
- Certified Registered Nurse Anesthetist
- Asheville, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 5576
- Practice address
- 7105 Davis Grey Dr
Asheville, NC 28803-0208 - Phone
- (662) 415-6574
- NPI assigned
- Dec 18, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 5576 | NC | Primary |
Addresses
Primary practice location
7105 Davis Grey Dr
Asheville, NC 28803-0208
Mailing address
50 Schenck Pkwy
Asheville, NC 28803-3499
Phone (828) 681-1527
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS, TN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211207002075 | MS | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 6901188770 | Reassigns benefits to 1 organization |
| I20230424002819 | TN | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 6901188770 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lifelinc Anesthesia PLLC
Practice addresses (Care Compare)
611 Alcorn Dr
Corinth, MS 38834-9321
Phone (662) 293-1000
935 Wayne Rd
Savannah, TN 38372-1904
Phone (731) 926-8000
Hospital & facility affiliations
- Magnolia Regional Health Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 901748 | MS | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifelinc Anesthesia, PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
634 Leigh Dr
Columbus, MS 39705
Phone (601) 978-3393
611 Alcorn Dr
Corinth, MS 38834
Phone (601) 286-6961
499 Azalea Dr
Oxford, MS 38655
Phone (662) 234-7979
2200 Union Ave
Memphis, TN 38104
Phone (901) 274-5813
3340 Players Club Pkwy
Ste 350
Memphis, TN 38125
Phone (901) 207-2017
935 Wayne Rd
Savannah, TN 38372
Phone (731) 925-4954
Organizations & group practices 1
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
- Memphis, TN
- NPI 1801021464
MS, Nurse Anesthetist, Certified Registered, TN
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": "1482019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482796800000",
"number": "1083158554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 SCHENCK PKWY",
"city": "ASHEVILLE",
"state": "NC",
"postal_code": "288033499",
"telephone_number": "828-681-1527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7105 DAVIS GREY DR",
"city": "ASHEVILLE",
"state": "NC",
"postal_code": "288030208",
"telephone_number": "662-415-6574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JACOB",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-12-18",
"last_updated": "2016-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NC",
"license": "5576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Asheville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.