Jessica Hailey Statz, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

E-13712 Issued in AR

Practice address

609 W Maple Ave
Springdale, AR 72764-5335

Phone

(479) 751-3722

Fax

(479) 751-1099

NPI assigned

Jan 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Jessica Wynne Statz Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO, OK, AR3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Anesthesiology

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integral Anesthesia LLC 159 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Integral Anesthesia, LLC

  • Anesthesiology Physician
  • Jenks, OK
  • NPI 1881041515

  Anesthesiology, OK

  Medicare reassignment Care Compare group NPD
• Totem Health PLLC

  • Family Medicine Physician
  • Springdale, AR
  • NPI 1770100752

  AR, Family Medicine

  Medicare reassignment NPD
• Boulder Valley Anesthesiology, PLLC

  • Anesthesiology Physician
  • Boulder, CO
  • NPI 1962431668

  Anesthesiology, CO

  Medicare reassignment NPD
• Diehl Anesthesia Inc

  • Anesthesiology Physician
  • Sedalia, CO
  • NPI 1467833897

  Anesthesiology, CO

  Medicare reassignment NPD
• Northeast Arkansas Clinic Charitable Foundation, Inc.

  • Anesthesiology Physician
  • Jonesboro, AR
  • NPI 1992036032

  Anesthesiology

  NPD (past)
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Union Grove, WI
  • NPI 1245440601
  NPD (past)
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St John Medical Center Inc

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1154417368

  Hospital

  Care Compare affiliation
• St John Medical Center Inc

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1578656161

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1215083993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W MAPLE AVE STE 503",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727645376",
            "telephone_number": "479-751-3722",
            "fax_number": "479-751-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 W MAPLE AVE",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727645335",
            "telephone_number": "479-751-3722",
            "fax_number": "479-751-1099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6901 W Edgerton Ave",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "WI",
            "postal_code": "532204420",
            "country_code": "US",
            "telephone_number": "414-423-5174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Balsam Ave",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803043404",
            "country_code": "US",
            "telephone_number": "303-415-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10350 E Dakota Ave",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802471314",
            "country_code": "US",
            "telephone_number": "303-338-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STATZ",
        "first_name": "JESSICA",
        "middle_name": "HAILEY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "DR.0043776",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "43776",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "52344-21",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E-13712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000165743",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10350 E Dakota Ave",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802471314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "STATZ",
            "middle_name": "WYNNE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kara Stanton, PT, DPT
• Amanda Star, AU.D.
• Cathryn Elizabeth Stark, OTR
• Jennifer E Stark, PHARM.D.
• Robert Adrian Stark, D.D.S.
• Chris Allen Stauffer, RN
• Steel Creek Counseling, LLC
• Alicia Gale Steele, MHPP
• Cori Anne Steele, PA-C
• Joan E Stein, RN

• All providers in Springdale, AR
• Anesthesiology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.