Jason Lee Ricks, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

2011020379 Issued in MO

Practice address

2817 Saint Johns Blvd
Anesthesia Dept
Joplin, MO 64804-1563

Phone

(417) 781-2727

NPI assigned

Jul 13, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Anesthesia of Arkansas Professional CorporationGroup PAC ID 6406077460, 87 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004

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 and National Provider Directory roles.

• Premier Anesthesia of Arkansas Professional Corporation

  • Anesthesiology Physician
  • Fayetteville, AR
  • NPI 1932519485

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD

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

• Washington Regional Medical Center

  • General Acute Care Hospital
  • Fayetteville, AR
  • NPI 1083609150
  Care Compare affiliation

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1104114073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 SAINT JOHNS BLVD",
            "address_2": "ANESTHESIA DEPT",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041563",
            "telephone_number": "417-781-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 SAINT JOHNS BLVD",
            "address_2": "ANESTHESIA DEPT",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041563",
            "telephone_number": "417-781-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKS",
        "first_name": "JASON",
        "middle_name": "LEE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-13",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2011020379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200397640A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188858001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104114073",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200739210A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Richardson, NP
• Heather Niccole Richardson, FNP-C
• Holly Rochelle Richardson, WHNP
• Terry J Richardson, MSW
• Matthew B Richins, DPM
• Riddles Beauty Supply
• Jenna M Rider
• Nathaniel Cashion Rider, MD
• Brandon D. Riesenmy, M.D.
• Michael Charles Rimar, R.PH.

• Certified Registered Nurse Anesthetist in Joplin, MO
• Providers in Joplin, MO by specialty
• Certified Registered Nurse Anesthetist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; 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.