Individual provider Active NPI

Jayne Willett

  • Certified Registered Nurse Anesthetist
  • Edgewood, KY
National Provider Identifier
1235644238
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN.415670 Issued in OH
Practice address
1 Medical Village Dr
Edgewood, KY 41017-3403
Phone
(859) 301-2000
NPI assigned
Dec 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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 RN.415670 OH Primary

Addresses

Primary practice location

1 Medical Village Dr
Edgewood, KY 41017-3403

Mailing address

PO Box 632572
Cincinnati, OH 45263-2572

Other practice location 1

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-2000

Other practice location 2

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-2000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180124002858 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678832466 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Group Practice IncGroup PAC ID 1254245137, 396 clinicians

Practice addresses (Care Compare)

10500 Montgomery Rd
Montgomery, OH 45242-4402
Phone (513) 865-1111

3660 Edgewood Dr
Cincinnati, OH 45211-1820
Phone (513) 591-6200

375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 862-2432

Hospital & facility affiliations

  • Good Samaritan Hospital Hospital, Cincinnati, OH, CCN 360134

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN.415670OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Group Practice, Inc Nurse Anesthetist, Certified Registered CurrentSince Dec 23, 2017 Accepting new patients
Sandusky Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 30, 2022 Accepting new patients

Locations

340 Thomas More Pkwy
Ste 220
Crestview Hills, KY 41017
Phone (859) 301-2211

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

7810 5 Mile Rd
Ste B
Cincinnati, OH 45230
Phone (513) 977-9640

6480 Harrison Ave
Ste 200
Cincinnati, OH 45247
Phone (513) 354-7787

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

600 N Pickaway St
Circleville, OH 43113
Phone (614) 352-6479

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

500 E Business Way
Sharonville, OH 45241
Phone (513) 251-7827

Organizations & group practices 2

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 5

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": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1235644238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632572",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-301-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Village Dr",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "KY",
            "postal_code": "410173403",
            "country_code": "US",
            "telephone_number": "859-301-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Village Dr",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "KY",
            "postal_code": "410173403",
            "country_code": "US",
            "telephone_number": "859-301-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLETT",
        "first_name": "JAYNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN.415670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.