Individual provider Active NPI

Jennifer M. Kinser, CRNA

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
National Provider Identifier
1235173444
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0111926 Issued in NC
Practice address
1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone
(704) 355-8983
Fax
(704) 355-8994
NPI assigned
Jun 16, 2006
Last updated
May 19, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2010

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 0111926 NC Primary

Addresses

Primary practice location

1000 Blythe Blvd
Charlotte, NC 28203-5812

Mailing address

PO Box 32861
Anesthesia SVCS - 5TH Floor Surgery Tower
Charlotte, NC 28232-2861
Phone (704) 355-8983

Other identifiers 2

IdentifierTypeStateIssuer
8052220MedicaidNC
NAN697MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040305000566 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5092603761 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

4400 Golf Acres Dr
Suite a
Charlotte, NC 28208-5906

557 Brookdale Dr
Statesville, NC 28677-4107
Phone (704) 873-5661

9412 Rosalyn Glen Rd
Cornelius, NC 28031-5748

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0111926NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Iredell Memorial Hospital Incorporated CurrentSince Sep 1, 2018 Accepting new patients
Iredell Physician Network LLC CurrentSince Jan 5, 2026 Accepting new patients
Iredell Physician Network, LLC CurrentSince Jan 5, 2026 Accepting new patients
Iredell Memorial Hospital, Incorporated CurrentSince Sep 1, 2018 Accepting new patients
Imh Prof Infect Disease PastSince Jan 1, 1990 Accepting new patients
Imh Professional Path PastSince Jan 1, 1990 Accepting new patients
Imh Professional ER PastSince Jan 1, 1990 Accepting new patients
Iredell Memorial Hospital Incorporated PastSince Jan 1, 1990 Accepting new patients
Iredell Mem Hospital Cap Program PastSince Jan 1, 1990 Accepting new patients
Iredell Memorial Hospital SNF Icf PastSince Jan 1, 1990 Accepting new patients
Iredell Memorial Hospital Incorporated PastSince Jan 1, 1990 Accepting new patients
Carolinas Rehabilitation Past Accepting new patients
Carolinas Rehabilitation Past Accepting new patients
Iredell Memorial Hosp SNF Icf PastSince Jan 1, 1990 Accepting new patients

Locations

653 Bluefield Rd
Ste D
Mooresville, NC 28117
Phone (704) 360-6470

557 Brookdale Dr
Statesville, NC 28677
Phone (330) 445-4361

766 Hartness Rd
Statesville, NC 28677
Phone (704) 838-2182

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/1faf3cea-e504-4363-85be-017534ea9e27/

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

Hospital & facility affiliations 1

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1235173444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32861",
            "address_2": "ANESTHESIA SVCS - 5TH FLOOR SURGERY TOWER",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282322861",
            "telephone_number": "704-355-8983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-355-8983",
            "fax_number": "704-355-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSER",
        "first_name": "JENNIFER",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "0111926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8052220",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NAN697",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; 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.