Jacob Payne Smith, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

0940 Issued in AZ

Practice address

77 W Forest Ave Ste 117
Flagstaff, AZ 86001-1482

Phone

(928) 773-2505

Fax

(928) 773-2504

NPI assigned

Dec 9, 2011

Last updated

Sep 24, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ, MT, TX3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Community Hospital of AnacondaGroup PAC ID 8123938974, shared by 5 NPIs, 45 clinicians

Mid Tex Anesthesia Associates, P.a.Group PAC ID 5395815369, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hendrick Medical Center Brownwood Hospital, Brownwood, TX, CCN 450587
• Nacogdoches Medical Center Hospital, Nacogdoches, TX, CCN 450656
• Seton Medical Center Harker Heights Hospital, Harker Heights, TX, CCN 670080
• Sidney Health Center Hospital, Sidney, MT, CCN 271344
• Ascension Providence Hospital, Waco, TX, CCN 450042

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergenchealth PLLC

  • Anesthesiology Physician
  • Fort Worth, TX
  • NPI 1467970897

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Mid Tex Anesthesia Associates, PA

  • Anesthesiology Physician
  • Waco, TX
  • NPI 1174612857
  Medicare reassignment Care Compare group NPD
• Anesthesia Partners & Management LLC

  dba Arizona Anesthesia Solutions

  • Certified Registered Nurse Anesthetist
  • Brighton, MI
  • NPI 1336530997

  AZ, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Community Hospital of Anaconda

  • Critical Access Hospital
  • Anaconda, MT
  • NPI 1205887924
  Medicare reassignment NPD
• Community Hospital of Anaconda

  dba Pintler Family Medicine East

  • Family Medicine Physician
  • Anaconda, MT
  • NPI 1538597703
  Medicare reassignment NPD
• Northstar Anesthesia, PA

  • Anesthesiology Physician
  • Arlington, TX
  • NPI 1912978610

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• St. John's Lutheran Hospital, Inc.

  dba Cabinet Peaks Medical Center

  • Critical Access Hospital
  • Libby, MT
  • NPI 1952312050
  Medicare reassignment NPD
• Elevated Anesthesia LLC

  • Anesthesiology Physician
  • Flagstaff, AZ
  • NPI 1720590672
  NPD
• Community Hospital of Anaconda

  dba Pintler Orthopedics and Spine

  • Surgery Physician
  • Anaconda, MT
  • NPI 1023623675
  NPD
• Community Hospital of Anaconda

  dba Pintler General and Thoracic Surgery

  • Surgery Physician
  • Anaconda, MT
  • NPI 1639345341
  NPD
• Sidney Health Center

  • Critical Access Hospital
  • Sidney, MT
  • NPI 1285719161
  NPD
• Sidney Health Center

  dba Sidney Health Center Clinic

  • Clinic/Center
  • Sidney, MT
  • NPI 1376617191
  NPD

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

• Ascension Providence

  • General Acute Care Hospital
  • Waco, TX
  • NPI 1093708679
  Care Compare affiliation
• Hendrick Medical Center Brownwood

  • General Acute Care Hospital
  • Brownwood, TX
  • NPI 1184233785
  Care Compare affiliation
• HH Killeen Health System LLC

  dba Seton Medical Center Harker Heights

  • General Acute Care Hospital
  • Harker Heights, TX
  • NPI 1841562709
  Care Compare affiliation
• Sidney Health Center

  • Critical Access Hospital
  • Sidney, MT
  • NPI 1285719161
  Care Compare affiliation
• TH Healthcare, LTD

  dba Nacogdoches Medical Center

  • General Acute Care Hospital
  • Nacogdoches, TX
  • NPI 1700885076
  Care Compare affiliation

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1275801870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE STE 117",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011482",
            "telephone_number": "928-773-2505",
            "fax_number": "928-773-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE STE 117",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011482",
            "telephone_number": "928-773-2505",
            "fax_number": "928-773-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACOB",
        "middle_name": "PAYNE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-09",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "100091",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "0940",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "203222",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274331YPVE",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Austin Smith, LCSW
• Benjamin J Smith, AU.D
• Charles Smith, MD
• Derek Beeson Smith, MD
• Haley Dawn Smith, RD
• Jamie Sue Smith, M.ED.
• Judith Smith, LCSW
• Kristen Ann Smith, PTA
• Libby Smith, ED.D. PH.D.
• Madeline Kidd Smith, CRNA

• Certified Registered Nurse Anesthetist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Certified Registered Nurse Anesthetist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.