Active NPI
Yvonne Woodford Jackson, CRNA
- Certified Registered Nurse Anesthetist
- Canton, OH
National Provider Identifier
1104853837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN169055
- Practice address
- 2600 Sixth Street SW
Ohio Hospital Based Physician Corp
Canton, OH 44710 - Phone
- (330) 363-7462
- Fax
- (330) 363-7679
- NPI assigned
- Jun 27, 2006
- Sex
- Female
- 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 | RN169055 | OH | Primary |
Addresses
Primary practice location
2600 Sixth Street SW
Ohio Hospital Based Physician Corp
Canton, OH 44710
Mailing address
2600 Sixth Street SW
Ohio Hospital Based Physician Corp
Canton, OH 44710
Phone (330) 363-7462
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0887090 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 80.19 of 100
- Quality
- 63.25
- Promoting interoperability
- 98
- Improvement activities
- 40
- Cost
- 72.4
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.62 of 100
- Quality
- 77.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.58
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN169055 | OH | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aultman Deuble Heart & Vascular Hospital, LLC | Current | Accepting new patients |
Locations
2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180
2600 6th St SW
Ste A2800
Canton, OH 44710
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.
-
- Cardiovascular Disease Physician
- Canton, OH
- NPI 1306495718
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104853837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 SIXTH STREET SW",
"address_2": "OHIO HOSPITAL BASED PHYSICIAN CORP",
"city": "CANTON",
"state": "OH",
"postal_code": "44710",
"telephone_number": "330-363-7462",
"fax_number": "330-363-7679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 SIXTH STREET SW",
"address_2": "OHIO HOSPITAL BASED PHYSICIAN CORP",
"city": "CANTON",
"state": "OH",
"postal_code": "44710",
"telephone_number": "330-363-7462",
"fax_number": "330-363-7679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "YVONNE",
"middle_name": "WOODFORD",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OH",
"license": "RN169055",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0887090",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.