Individual provider Active NPI

Jenna Carlson Parden, CRNA

  • Certified Registered Nurse Anesthetist
  • Dothan, AL
National Provider Identifier
1205131497
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-109200 Issued in AL
Practice address
1118 Ross Clark Cir
Suite 700
Dothan, AL 36301-3030
Phone
(334) 793-5105
Fax
(334) 671-5073
NPI assigned
Jan 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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 1-109200 AL Primary

Addresses

Primary practice location

1118 Ross Clark Cir
Suite 700
Dothan, AL 36301-3030

Mailing address

1118 Ross Clark Cir
Suite 700
Dothan, AL 36301-3030
Phone (334) 793-5105

Other identifiers 1

IdentifierTypeStateIssuer
1-109200OtherALAL LICENSE

Other names 1

  • Jenna Layne Carlson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110210000542 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365622107 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Laboratory Associates Current Accepting new patients
Houston County Healthcare Authority CurrentSince Feb 1, 2018 Accepting new patients
Medcore Associates, PLLC Current Accepting new patients
Anesthesia Consultants Medical Group PC Nurse Anesthetist, Certified Registered CurrentSince Jan 24, 2011 Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Houston County Healthcare Authority Nurse Anesthetist, Certified Registered Current Accepting new patients

Locations

1118 Ross Clark Cir
Ste 700
Dothan, AL 36301
Phone (334) 793-5105

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1205131497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 ROSS CLARK CIR",
            "address_2": "SUITE 700",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013030",
            "telephone_number": "334-793-5105",
            "fax_number": "334-671-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 ROSS CLARK CIR",
            "address_2": "SUITE 700",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013030",
            "telephone_number": "334-793-5105",
            "fax_number": "334-671-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARDEN",
        "first_name": "JENNA",
        "middle_name": "CARLSON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-19",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-109200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL LICENSE",
            "identifier": "1-109200",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "CARLSON",
            "middle_name": "LAYNE",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.