Jack Gilbert Weiss, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

CRNA0011 Issued in AZ

Practice address

77 W Forest Ave
Suite 207
Flagstaff, AZ 86001-1479

Phone

(928) 773-2505

Fax

(928) 773-2504

NPI assigned

Aug 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1174534754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE",
            "address_2": "SUITE 207",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011479",
            "telephone_number": "928-773-2505",
            "fax_number": "928-773-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE",
            "address_2": "SUITE 207",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011479",
            "telephone_number": "928-773-2505",
            "fax_number": "928-773-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "JACK",
        "middle_name": "GILBERT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "CRNA0011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363242",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Becky Yvonne Weidinger, L.M.
• Jordyn Rae Weidle, OTR/L
• Lauren Marie Weinand, MD
• Lani Kai Weis, LMT
• Adam P Weiss, M.D.
• Welbrook Senior Living Flagstaff LLC
• Cassidy Welch, MSW, LMSW
• Sherrill L Weller, D.O.
• Briana Truehill Wellington, M.D.
• Aaron Wells, RN

• Certified Registered Nurse Anesthetist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Certified Registered Nurse Anesthetist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.