Individual provider Active NPI

Jonathan Wayne Barnett, CRNA

  • Certified Registered Nurse Anesthetist
  • Carlsbad, NM
National Provider Identifier
1174864680
Registry record updated Oct 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA-01362 Issued in NM
Practice address
2430 W Pierce St
Carlsbad, NM 88220-3553
Phone
(575) 887-4100
NPI assigned
Mar 7, 2013
Last updated
Oct 8, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0001224032 VA
Certified Registered Nurse Anesthetist 367500000X CRNA-01362 NM Primary

Addresses

Primary practice location

2430 W Pierce St
Carlsbad, NM 88220-3553

Mailing address

PO Box 1547
Sedalia, MO 65302-1547
Phone (660) 826-5960

Other identifiers 1

IdentifierTypeStateIssuer
45755264MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160608000228 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062654353 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Ozark Anesthesia and Associates, IncGroup PAC ID 6305806530, 22 clinicians

Practice addresses (Care Compare)

1600 N 2ND St
Clinton, MO 64735-1192
Phone (660) 885-5511

1602 N 2ND St
Clinton, MO 64735-1192

54 Hospital Dr
Osage Beach, MO 65065-3050
Phone (573) 348-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
CRNA-01362NMMDCertified Registered Nurse Anesthetist
0001224032VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Ozark Anesthesia & Associates, Inc CurrentSince Jun 13, 2016 Accepting new patients
Lake of the Ozarks Pain Management Services, Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Commonwealth Anesthesia Associates, P.C. Past Accepting new patients

Locations

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1174864680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1547",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653021547",
            "telephone_number": "660-826-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 W PIERCE ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203553",
            "telephone_number": "575-887-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNETT",
        "first_name": "JONATHAN",
        "middle_name": "WAYNE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-07",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0001224032",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "CRNA-01362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45755264",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.

Verify at the official NPI Registry.