Katrina A Jackson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

C00815 Issued in AR

Practice address

500 S. University
Suite 505
Little Rock, AR 72205-5307

Phone

(501) 664-4532

Fax

(501) 663-4335

NPI assigned

Oct 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Arkansas Health Group

  • Anesthesiology Physician
  • Little Rock, AR
  • NPI 1508800962
  Medicare reassignment NPD
• Arkansas Health Group

  • Surgery Physician
  • Stuttgart, AR
  • NPI 1952840555
  NPD

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1144318296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S. UNIVERSITY",
            "address_2": "SUITE 505",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055307",
            "telephone_number": "501-664-4532",
            "fax_number": "501-663-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S. UNIVERSITY",
            "address_2": "SUITE 505",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055307",
            "telephone_number": "501-664-4532",
            "fax_number": "501-663-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KATRINA",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "C00815",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C00815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BLUE CROSS BLUE SHIELD",
            "identifier": "5S440",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Presley Jackson, M.D.
• Jasmine Jackson, NP
• Juleana Jackson, QBHP
• Kanesha Jackson
• Kara Jackson, DPT
• Kelly Elise Jackson, COTA/L
• Kenley Brooke Jackson, PT, DPT
• Kim Ngan Thi Jackson, MD
• Kimberly Ann Jackson, N/A ...NONE
• Kyle Everett Jackson, MD

• Certified Registered Nurse Anesthetist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.