Individual provider Active NPI

Jennifer Carol Rexroad, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Tulsa, OK
National Provider Identifier
1205831708
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R0062121 Issued in OK
Practice address
6839 S Canton Ave
Tulsa, OK 74136-3402
Phone
(918) 494-0612
Fax
(918) 481-5170
NPI assigned
Jun 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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 R0062121 OK Primary

Addresses

Primary practice location

6839 S Canton Ave
Tulsa, OK 74136-3402

Mailing address

903 N Osage St
Chouteau, OK 74337-3777
Phone (918) 476-7779

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100826001019 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264556323 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osh Aai PLLCGroup PAC ID 4587818729, 73 clinicians
Associated Anesthesiologists, Inc.Group PAC ID 7911989017, 111 clinicians

Practice addresses (Care Compare)

6839 S Canton Ave
Tulsa, OK 74136-3402
Phone (918) 494-0612

Hospital & facility affiliations

  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091
  • Oklahoma Surgical Hospital, LLC Hospital, Tulsa, OK, CCN 370210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Osh Aai PLLC CurrentSince Jan 26, 2013 Accepting new patients

Locations

6839 S Canton Ave
Tulsa, OK 74136
Phone (918) 494-0612

2408 E 81st St
Ste 900
Tulsa, OK 74137
Phone (918) 477-5000

Organizations & group practices 2

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 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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1205831708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 N OSAGE ST",
            "city": "CHOUTEAU",
            "state": "OK",
            "postal_code": "743373777",
            "telephone_number": "918-476-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6839 S CANTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363402",
            "telephone_number": "918-494-0612",
            "fax_number": "918-481-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REXROAD",
        "first_name": "JENNIFER",
        "middle_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-20",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "R0062121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.