Individual provider Active NPI

Jennifer Myles, CRNA

  • Certified Registered Nurse Anesthetist
  • Fayetteville, NC
National Provider Identifier
1194002998
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
216875 Issued in NC
Practice address
1638 Owen Dr
Fayetteville, NC 28304-3424
Phone
(910) 615-5132
Fax
(910) 321-6236
NPI assigned
Nov 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 216875 NC Primary

Addresses

Primary practice location

1638 Owen Dr
Fayetteville, NC 28304-3424

Mailing address

PO Box 40908
Fayetteville, NC 28309-0908
Phone (910) 615-6448

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JMYLES510173@DIRECT.NOVANTHEALTH.ORG

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111202000471 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446425482 Reassigns benefits to 15 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians

Practice addresses (Care Compare)

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
216875NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Mint Hill Medical Center, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2018 Accepting new patients
Presbyterian Sameday Surgery Center at Ballantyne LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 30, 2017 Accepting new patients
Forsyth Memorial Hospital, Inc. Nurse Anesthetist, Certified Registered CurrentSince May 25, 2020 Accepting new patients
Brunswick Community Hospital, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 30, 2017 Accepting new patients
Novant Health Thomasville Medical Center LLC CurrentSince May 25, 2020 Accepting new patients
Novant Health Matthews Medical Center LLC CurrentSince Oct 30, 2017 Accepting new patients
Novant Health Clemmons Outpatient Surgery, LLC CurrentSince May 25, 2020 Accepting new patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 21, 2015 Accepting new patients
Novant Health Kernersville Outpatient Surgery LLC CurrentSince May 25, 2020 Accepting new patients
Novant Health Clemmons Outpatient Surgery, LLC Nurse Anesthetist, Certified Registered CurrentSince May 25, 2020 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince May 25, 2020 Accepting new patients
Novant Health Rowan Medical Center, LLC CurrentSince Oct 30, 2017 Accepting new patients
Presbyterian Sameday Surgery Center at Ballantyne LLC Current Accepting new patients
The Presbyterian Hospital Current Accepting new patients
American Anesthesiology of North Carolina, PLLC Current Accepting new patients
Presbyterian Sameday Surgery Center at Huntersville LLC Current Accepting new patients
Novant Health Rowan Medical Center LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 30, 2017 Accepting new patients
The Presbyterian Hospital CurrentSince Oct 30, 2017 Accepting new patients
Novant Health Thomasville Medical Center, LLC Nurse Anesthetist, Certified Registered CurrentSince May 25, 2020 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 21, 2015 Accepting new patients
Novant Health Ballantyne Medical Center LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2023 Accepting new patients
Presbyterian Sameday Surgery Center at Huntersville LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 30, 2017 Accepting new patients
Novant Health Kernersville Outpatient Surgery LLC Nurse Anesthetist, Certified Registered CurrentSince May 25, 2020 Accepting new patients
Medical Park Hospital LLC CurrentSince May 25, 2020 Accepting new patients
Providence Anesthesiology Associates, P.a. CurrentSince Jun 1, 2020 Accepting new patients
Medical Park Hospital LLC CurrentSince May 25, 2020 Accepting new patients
The Presbyterian Hospital CurrentSince Oct 30, 2017 Accepting new patients

Locations

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

14215 Ballantyne Corporate Pl
Ste 210
Charlotte, NC 28277
Phone (704) 316-2650

8201 Healthcare Loop
Charlotte, NC 28215
Phone (980) 302-1000

10905 Providence Rd W
Charlotte, NC 28277
Phone (980) 488-4000

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

7210 Village Medical Cir
Ste 235
Clemmons, NC 27012
Phone (336) 893-3100

10030 Gilead Rd
Huntersville, NC 28078
Phone (704) 316-4000

1730 Kernersville Medical Pkwy
Ste 304
Kernersville, NC 27284
Phone (336) 515-7000

1500 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 384-6500

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

1950 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 718-0600

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Interoperability endpoints

  • Direct secure messaging: jmyles510173@direct.novanthealth.org

Organizations & group practices 28

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.

View all 28

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": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1194002998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40908",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283090908",
            "telephone_number": "910-615-6448",
            "fax_number": "910-615-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-5132",
            "fax_number": "910-321-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYLES",
        "first_name": "JENNIFER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-08",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "216875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JMYLES510173@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "1638 Owen Dr",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283043424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.