Active NPI
Jeffrey Scott Medders, CRNA
- Certified Registered Nurse Anesthetist
- Tuscaloosa, AL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 1-066895
- Practice address
- 809 University Blvd E
Tuscaloosa, AL 35401-2029 - Phone
- (205) 759-7352
- Fax
- (205) 759-6397
- NPI assigned
- Jun 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1-066895 | AL | |
| Certified Registered Nurse Anesthetist | 367500000X | 1-066895 | AL | Primary |
Addresses
Primary practice location
809 University Blvd E
Tuscaloosa, AL 35401-2029
Mailing address
809 University Blvd E
Tuscaloosa, AL 35401-2029
Phone (205) 759-7352
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 075123 | Other | AL | AMERICAN ASSOCIATION OF NURSE ANESTHETISTS (CERTIFICATION) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2700 Hospital Dr
Northport, AL 35476-3360
Phone (205) 333-4500
Hospital & facility affiliations
- DCH Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-066895 | AL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DCH Medical Center Crna | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Northport - Crna | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
2700 Hospital Dr
Northport, AL 35476
Phone (205) 333-4500
809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661
Organizations & group practices 2
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.
-
- Certified Registered Nurse Anesthetist
- Northport, AL
- NPI 1265734271
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Tuscaloosa, AL
- NPI 1356642045
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tuscaloosa, AL
- NPI 1841394418
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288915200000",
"number": "1154364735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "809 UNIVERSITY BLVD E",
"city": "TUSCALOOSA",
"state": "AL",
"postal_code": "354012029",
"telephone_number": "205-759-7352",
"fax_number": "205-759-6397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 UNIVERSITY BLVD E",
"city": "TUSCALOOSA",
"state": "AL",
"postal_code": "354012029",
"telephone_number": "205-759-7352",
"fax_number": "205-759-6397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDDERS",
"first_name": "JEFFREY",
"middle_name": "SCOTT",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2010-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AL",
"license": "1-066895",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AL",
"license": "1-066895",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN ASSOCIATION OF NURSE ANESTHETISTS (CERTIFICATION)",
"identifier": "075123",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tuscaloosa, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.