Individual provider Active NPI

Jordan Crumrine, CRNA

  • Certified Registered Nurse Anesthetist
  • Odessa, TX
National Provider Identifier
1104278498
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
789218 Issued in TX
Practice address
520 E 6TH St
Odessa, TX 79761-4527
Phone
(432) 332-0929
Fax
(888) 575-9993
NPI assigned
Jul 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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 789218 TX Primary

Addresses

Primary practice location

520 E 6TH St
Odessa, TX 79761-4527

Mailing address

PO Box 1226
Odessa, TX 79760-1226
Phone (432) 332-0929

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160930000229 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486941762 Reassigns benefits to 3 organizations

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
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Practice addresses (Care Compare)

315 E 5TH St
Odessa, TX 79761-5133
Phone (432) 335-8300

520 E 6TH St
Odessa Reg Med Ctr
Odessa, TX 79761-4527
Phone (432) 582-8700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
789218TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Medical Group of the Permian Basin, LLP CurrentSince Jun 15, 2024 Accepting new patients
BHS Physicians Network, Inc CurrentSince Nov 23, 2024 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2024 Accepting new patients
BHS Physicians Network, Inc CurrentSince Nov 23, 2024 Accepting new patients

Locations

5609 Deauville
Midland, TX 79706
Phone (432) 697-3629

315 E 5th St
Odessa, TX 79761
Phone (432) 333-3433

520 E 6th St
Odessa, TX 79761
Phone (432) 332-0929

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

4 Burnside
#100
Wichita Falls, TX 76310
Phone (940) 400-6400

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 and National Provider Directory roles.

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": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1104278498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1226",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797601226",
            "telephone_number": "432-332-0929",
            "fax_number": "888-575-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E 6TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614527",
            "telephone_number": "432-332-0929",
            "fax_number": "888-575-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMRINE",
        "first_name": "JORDAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "789218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.

Verify at the official NPI Registry.