Individual provider Active NPI

Jeslyn A. Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • Olathe, KS
National Provider Identifier
1104117886
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
557027 Issued in KS
Practice address
20375 W 151St St
Suite 306
Olathe, KS 66061-5306
Phone
(913) 782-2292
Fax
(913) 782-2381
NPI assigned
Apr 28, 2011
Last updated
Mar 28, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 557027 KS Primary
Registered Nurse 163W00000X 96296 KS

Addresses

Primary practice location

20375 W 151St St
Suite 306
Olathe, KS 66061-5306

Mailing address

20375 W 151St St
Suite 306
Olathe, KS 66061-5306
Phone (913) 782-2292

Other identifiers 2

IdentifierTypeStateIssuer
200733680AMedicaidKS
P00970186OtherKSRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110823000976 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 5092985374 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Specialists LLCGroup PAC ID 1456883669, 7 clinicians
Anesthesia Associates of Kansas City PAGroup PAC ID 1951206168, 214 clinicians

Practice addresses (Care Compare)

10787 Nall Ave
Overland Park, KS 66211-1375
Phone (913) 385-4440

5525 W 119TH St
100 Mid America Surgery Institute
Overland Park, KS 66209-3723
Phone (913) 906-0855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
96296KSMDRegistered Nurse
557027KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Kansas City PA CurrentSince Aug 28, 2023 Accepting new patients
Johnson County Anesthesiologists, Chartered Past Accepting new patients

Locations

10730 Nall Ave
Ste 100
Overland Park, KS 66211
Phone (913) 428-9000

5525 W 119th St
Ste 100
Overland Park, KS 66209
Phone (913) 906-0837

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.

NPI Registry JSON

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395964800000",
    "number": "1104117886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20375 W 151ST ST",
            "address_2": "SUITE 306",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660615306",
            "telephone_number": "913-782-2292",
            "fax_number": "913-782-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20375 W 151ST ST",
            "address_2": "SUITE 306",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660615306",
            "telephone_number": "913-782-2292",
            "fax_number": "913-782-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JESLYN",
        "middle_name": "A.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-28",
        "last_updated": "2014-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "557027",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "96296",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200733680A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00970186",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.