Individual provider Active NPI

Jacob Robert Hafner, CRNA

  • Certified Registered Nurse Anesthetist
  • Nashville, TN
National Provider Identifier
1174930911
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN19104 Issued in TN
Practice address
391 Wallace Rd
Nashville, TN 37211-4851
Phone
(615) 781-4000
NPI assigned
Jul 14, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN0000174196 TN
Certified Registered Nurse Anesthetist 367500000X APN19104 TN Primary

Addresses

Primary practice location

391 Wallace Rd
Nashville, TN 37211-4851

Mailing address

121 Burberry Glen Blvd
Nolensville, TN 37135-2103
Phone (931) 267-8567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141021000792 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840411674 Reassigns benefits to 2 organizations
I20201221001182 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840411674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

723 Burkesville Rd
Albany, KY 42602-1654
Phone (270) 796-6333

Hospital & facility affiliations

  • The Medical Center at Albany Hospital, Albany, KY, CCN 181333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN0000174196TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Tennessee, P.C. CurrentSince Sep 18, 2014 Accepting new patients
Commonwealth Health Corporation, Inc. CurrentSince Nov 9, 2020 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Sep 18, 2014 Accepting new patients
Commonwealth Health Corporation, Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 9, 2020 Accepting new patients
Commonwealth Health Corporation, Inc Current Accepting new patients
Nashville Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2016 Accepting new patients
Anesthesiologists Associated PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesiologists Associated PC Past Accepting new patients

Locations

723 Burkesville Rd
Albany, KY 42602
Phone (606) 387-6421

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

501 20th St
Ste 606
Knoxville, TN 37916
Phone (865) 331-2278

391 Wallace Rd
Nashville, TN 37211
Phone (615) 332-6253

397 Wallace Rd
Ste 407
Nashville, TN 37211
Phone (615) 832-5530

200 Stonecrest Blvd
Smyrna, TN 37167
Phone (615) 768-2000

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1174930911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 BURBERRY GLEN BLVD",
            "city": "NOLENSVILLE",
            "state": "TN",
            "postal_code": "371352103",
            "telephone_number": "931-267-8567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 WALLACE RD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372114851",
            "telephone_number": "615-781-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFNER",
        "first_name": "JACOB",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-14",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN0000174196",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN19104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.