Lisa Ann Jackson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

081637 Issued in PA

Practice address

2010 Old W Chester Pike
Suite 330
Havertown, PA 19083-2712

Phone

(610) 789-8070

Fax

(610) 789-9937

NPI assigned

Jan 16, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Lisa Ann Vignola Jackson Former name

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Einstein Montgomery Hospital Hospital, East Norriton, PA, CCN 390329

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/0d26bd04-9128-4f58-8e6d-ffda5cd00f89/

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.

• Einstein Practice Plan Inc

  dba Einstein Psychiatry Assoc

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1760434468
  Medicare reassignment Care Compare group NPD
• Associates in Anesthesia, Inc.

  • Anesthesiology Physician
  • Chadds Ford, PA
  • NPI 1942281191
  Medicare reassignment NPD
• Temple Faculty Practice Plan Inc

  dba Temple Faculty Anesthesiology Associates

  • Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1881176949
  Medicare reassignment NPD
• Einstein Practice Plan Inc

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
  • NPI 1457047433

  Nurse Anesthetist, Certified Registered

  NPD
• Einstein Practice Plan Inc

  dba Einstein Anesthesia Associates

  • Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1740232321
  NPD
• Temple Faculty Practice Plan, Inc

  dba Temple Faculty Critical Care Associates

  • Critical Care Medicine (Internal Medicine) Physician
  • Philadelphia, PA
  • NPI 1679056352
  NPD
• Temple Faculty Practice Plan Inc

  dba Temple Faculty Multi-Specialty at NJ

  • Urology Physician
  • Voorhees, NJ
  • NPI 1407638794
  NPD
• Associates in Anesthesia

  • Anesthesiology Physician
  • Chadds Ford, PA
  • NPI 1336470467
  NPD (past)
• Pinnacle Mid-Atlantic Anesthesia Associates PC

  • Anesthesiology Physician
  • Pottsville, PA
  • NPI 1073789244

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

• Einstein Medical Center Montgomery

  • General Acute Care Hospital
  • East Norriton, PA
  • NPI 1104192590
  Care Compare affiliation

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232064000000",
    "number": "1215174990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650782",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75265",
            "telephone_number": "610-789-8070",
            "fax_number": "610-789-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 OLD W CHESTER PIKE",
            "address_2": "SUITE 330",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832712",
            "telephone_number": "610-789-8070",
            "fax_number": "610-789-9937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LISA ANN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-16",
        "last_updated": "2009-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "081637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN328670L",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANA",
            "identifier": "081637",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA ANN",
            "last_name": "JACKSON",
            "middle_name": "VIGNOLA",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Integrative Life Services
• Integrative OT LLC
• William S Isaacson, MD
• Lindsay Iser
• Merita K Jackson Hinds, OMD
• Charles Jason Jacob, PH.D.
• James L Jacobs
• Mark Jacobs, MD
• Richard L. Jahnle, M.D.
• Shailen Jalali, MD

• Certified Registered Nurse Anesthetist in Havertown, PA
• Providers in Havertown, PA by specialty
• Certified Registered Nurse Anesthetist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; 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.