Jared Y Robertson III, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

901491 Issued in MS

Practice address

149 Drinkwater Rd
Bay St Louis, MS 39520-1658

Phone

(228) 467-8600

NPI assigned

Sep 21, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 8

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in LA, TX, MS, CO4 enrollments

Enrollment records 4

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novus Colorado Professional CorporationGroup PAC ID 0840694774, 12 clinicians

Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Animas Surgical Hospital LLCGroup PAC ID 0143295428, 61 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Animas Surgical Hospital, LLC Hospital, Durango, CO, CCN 060117
• Scenic Mountain Medical Center Hospital, Big Spring, TX, CCN 450653

Medicare enrollment (NPD)

Enrolled

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.

• Animas Surgical Hospital, LLC

  • Emergency Medicine Physician
  • Durango, CO
  • NPI 1861721714

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Emergenchealth PLLC

  • Anesthesiology Physician
  • Fort Worth, TX
  • NPI 1467970897

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Novus Colorado Professional Corporation

  • Anesthesiology Physician
  • Cortez, CO
  • NPI 1437723640

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Ochsner Mississippi, LLC

  • Internal Medicine Physician
  • Bay Saint Louis, MS
  • NPI 1538674239
  Medicare reassignment NPD
• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1538151428
  Medicare reassignment NPD
• Ochsner Mississippi, LLC

  • Internal Medicine Physician
  • Diamondhead, MS
  • NPI 1316662059
  NPD
• Ochsner Mississippi, LLC

  • Internal Medicine Physician
  • Picayune, MS
  • NPI 1487253407
  NPD
• Animas Surgical Hospital, LLC

  • Urgent Care Clinic/Center
  • Durango, CO
  • NPI 1194161422
  NPD
• Durango Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Durango, CO
  • NPI 1548870603
  NPD
• Ochsner Clinic LLC

  • Registered Dietitian
  • Covington, LA
  • NPI 1013747039
  NPD
• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1932648714
  NPD
• American Anesthesiology Group of Tennessee, P. C.

  • Anesthesiology Physician
  • Kingsport, TN
  • NPI 1114927738

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

• Animas Surgical Hospital, LLC

  • Internal Medicine Physician
  • Durango, CO
  • NPI 1184178238

  Hospital

  Care Compare affiliation
• Animas Surgical Hospital, LLC

  • Urgent Care Clinic/Center
  • Durango, CO
  • NPI 1194161422

  Hospital

  Care Compare affiliation
• Animas Surgical Hospital, LLC

  • Occupational Medicine Physician
  • Durango, CO
  • NPI 1497071435

  Hospital

  Care Compare affiliation
• Animas Surgical Hospital, LLC

  • General Acute Care Hospital
  • Durango, CO
  • NPI 1508842964
  Care Compare affiliation
• Big Spring Texas Hospital Company LLC

  • General Acute Care Hospital
  • Big Spring, TX
  • NPI 1336976034
  Care Compare affiliation

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1265428734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 DRINKWATER RD",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "395201658",
            "telephone_number": "228-467-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JARED",
        "middle_name": "Y",
        "name_suffix": "III",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "10597",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "5201",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "4858A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "24167318",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "3625",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "71550",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "144482",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "901491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010103894",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF TN",
            "identifier": "4081487",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74008541",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN0100",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100045319",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3632282",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHC CARE ADMINISTRATORS",
            "identifier": "00013859",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "146158",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Amanda Ring, LMSW
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• Rowe S Crowder III MD PLLC
• Rubys Gentle Touch Home Care LLC
• Scott Edward Sanders, O.D.
• Elizabeth Ann Seal, NP-C

• Certified Registered Nurse Anesthetist in Bay St Louis, MS
• Providers in Bay St Louis, MS by specialty
• Certified Registered Nurse Anesthetist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.