Individual provider Active NPI

Jillian R Smith, CRNA

  • Certified Registered Nurse Anesthetist
  • Memphis, TN
National Provider Identifier
1235628785
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
24669 Issued in TN
Practice address
1265 Union Ave
Memphis, TN 38104-3415
Phone
(901) 725-5846
NPI assigned
May 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 189649 TN
Certified Registered Nurse Anesthetist 367500000X 24669 TN Primary

Addresses

Primary practice location

1265 Union Ave
Memphis, TN 38104-3415

Mailing address

6060 Primacy Pkwy Ste 241
Memphis, TN 38119-5743
Phone (901) 725-5846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS, NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20181101001818 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062765456 Reassigns benefits to 2 organizations
I20200730003964 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062765456 Reassigns benefits to 2 organizations
I20250429000574 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062765456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians

Practice addresses (Care Compare)

800 N Justice St
Hendersonville, NC 28791-3410
Phone (828) 696-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.75 of 100Reported as group
Quality
83.24
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
901617MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 24, 2025 Accepting new patients
Medical Anesthesia Group, PA CurrentSince Aug 20, 2018 Accepting new patients
Resource Anesthesiology Associates of TN PC Nurse Anesthetist, Certified Registered CurrentSince Jan 5, 2024 Accepting new patients

Locations

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

7580 Clarington Cv
Southaven, MS 38671
Phone (901) 259-1600

800 N Justice St
Hendersonvlle, NC 28791
Phone (828) 696-1000

830 Rockford St
Mount Airy, NC 27030
Phone (336) 719-7000

450 Mamaroneck Ave
Ste 201
Harrison, NY 10528
Phone (877) 476-6642

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

6060 E Primacy Pkwy
Ste 241
Memphis, TN 38119
Phone (901) 725-5846

1265 Union Ave
Ste 201
Memphis, TN 38104
Phone (901) 516-7000

1300 Wesley Dr
Memphis, TN 38116
Phone (901) 516-3700

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

Organizations & group practices 3

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 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": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1235628785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6060 PRIMACY PKWY STE 241",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195743",
            "telephone_number": "901-725-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043415",
            "telephone_number": "901-725-5846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JILLIAN",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "189649",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "24669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; 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.