Individual provider Active NPI

Jennifer Hager, DNP, MBA, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Wayne, IN
National Provider Identifier
1093320038
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28179714A Issued in IN
Practice address
10315 Dawsons Creek Blvd Ste Ab
Fort Wayne, IN 46825
Phone
(260) 436-7875
Fax
(260) 432-9812
NPI assigned
Sep 15, 2020
Last updated
Jun 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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 28179714A IN Primary

Addresses

Primary practice location

10315 Dawsons Creek Blvd Ste Ab
Fort Wayne, IN 46825

Mailing address

PO Box 843603
Dallas, TX 75284-3603

Other practice location 1

1101 Michigan Ave
Logansport, IN 46947-1528
Phone (574) 753-7541

Other identifiers 1

IdentifierTypeStateIssuer
1093320038MedicaidIN

Other names 1

  • Jennifer Walsh Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201021001773 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547680068 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Anesthesiologists of Fort Wayne PCGroup PAC ID 2264412444, 101 clinicians

Practice addresses (Care Compare)

7950 W Jefferson Blvd
Lutheran Hospital
Fort Wayne, IN 46804-4140
Phone (260) 435-7001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.76 of 100Reported as group
Quality
62.07
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Business Administration

State licenses

LicenseStateTypeSpecialty
28179714AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
U S Anesthesia Partners of Kentucky PSC Nurse Anesthetist, Certified Registered CurrentSince Jun 30, 2024 Accepting new patients
Associated Anesthesiologists of Fort Wayne PC Nurse Anesthetist, Certified Registered CurrentSince Feb 15, 2024 Accepting new patients
Iceland Anesthesia Management, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 15, 2021 Accepting new patients
Clinical Colleagues LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2020 Accepting new patients

Locations

1316 E 7th St
Auburn, IN 46706
Phone (260) 925-4600

801 S Main St
Clinton, IN 47842
Phone (765) 832-1212

1260 E State Road 205
Columbia City, IN 46725
Phone (260) 248-9000

10315 Dawsons Creek Blvd
Ste Ab
Fort Wayne, IN 46825
Phone (219) 436-7875

1721 Magnavox Way
Fort Wayne, IN 46804
Phone (260) 250-0001

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

6435 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 436-7875

702 Van Buren St
Fort Wayne, IN 46802
Phone (260) 425-3000

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

7952 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 435-2836

1101 Michigan Ave
Logansport, IN 46947
Phone (574) 753-1475

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

2101 Dubois Dr
Warsaw, IN 46580
Phone (219) 267-3200

9 Northeastern Blvd
Ste 400
Salem, NH 03079

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1093320038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843603",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752843603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10315 DAWSONS CREEK BLVD STE AB",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46825",
            "telephone_number": "260-436-7875",
            "fax_number": "260-432-9812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Logansport",
            "state": "IN",
            "postal_code": "469471528",
            "country_code": "US",
            "telephone_number": "574-753-7541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGER",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "DNP, MBA, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-15",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28179714A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093320038",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WALSH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.