Individual provider Active NPI

Jared George Fox, CRNA

  • Certified Registered Nurse Anesthetist
  • Lake Charles, LA
National Provider Identifier
1205917010
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP04937 Issued in LA
Practice address
4150 Nelson Road
Building a Suite 4
Lake Charles, LA 70605-4196
Phone
(337) 474-6353
Fax
(337) 477-7616
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 AP04937 LA Primary

Addresses

Primary practice location

4150 Nelson Road
Building a Suite 4
Lake Charles, LA 70605-4196

Mailing address

4150 Nelson Road
Building a Suite 4
Lake Charles, LA 70605-4196
Phone (337) 474-6353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061025000284 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860499431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LCMS Cardiovascular Diseases, LLCGroup PAC ID 1951541515, 34 clinicians

Practice addresses (Care Compare)

1701 Oak Park Blvd
Lake Charles, LA 70601-8911
Phone (337) 494-3255

Hospital & facility affiliations

  • Lake Charles Memorial Hospital Hospital, Lake Charles, LA, CCN 190060

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
LCMS Cardiovascular Diseases, LLC CurrentSince Oct 1, 2018 Accepting new patients

Locations

1701 Oak Park Blvd
Lake Charles, LA 70601
Phone (337) 494-3000

Organizations & group practices 1

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205917010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 NELSON ROAD",
            "address_2": "BUILDING A SUITE 4",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054196",
            "telephone_number": "337-474-6353",
            "fax_number": "337-477-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 NELSON ROAD",
            "address_2": "BUILDING A SUITE 4",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054196",
            "telephone_number": "337-474-6353",
            "fax_number": "337-477-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "JARED",
        "middle_name": "GEORGE",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP04937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.