Jennifer Lee Allen, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Dalton, GA
NPI 1174248447 · NPPES record last updated Oct 10, 2022
Key facts
- NPI
- 1174248447
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- RN282512 (GA)
- Practice address
- 1200 Memorial Dr
Dalton, GA 30720-2529 - Phone
- (706) 272-6000
- NPI assigned
- Oct 10, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North Georgia Anesthesia Services PC
Southeastern Surgical, LLC
Practice addresses (Care Compare)
1200 Memorial Dr
Dalton, GA 30720-2529
Phone (706) 272-6000
1247 Riverfront Pkwy
Suite 100
Chattanooga, TN 37402-2108
Phone (423) 206-9000
Hospital & facility affiliations
- Hamilton Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA, TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221027001958 | GA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 0143697565 | Reassigns benefits to 1 organization |
| I20251106000773 | TN | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 0143697565 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39488 | TN | MD | Pharmacist |
| RN282512 | GA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Georgia Anesthesia Services PC | Current |
Accepting new patients | |
| Southeastern Surgical, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Southeastern Surgical, LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
Locations
1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115
1247 Riverfront Pkwy
Ste 100
Chattanooga, TN 37402
Phone (423) 206-9000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN282512 | GA | Yes |
Addresses
Primary practice location
1200 Memorial Dr
Dalton, GA 30720-2529
Mailing address
31 E Larry Cir
Ringgold, GA 30736-6409
Phone (615) 927-6734
Other providers in Dalton, GA
- Natalie Renee Ali
- Ali Aliman
- Shinette Alinas
- All Family Care LLC
- All-in Counseling & Telementalhealth, LLC
- John Allen
- Karen M. Allen
- Marlin Calvin Allen
- Patricia A Allen
- Claire Allman
All providers in Dalton, GA · Certified Registered Nurse Anesthetist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.