Individual provider Active NPI

Jean Gabriel Richard, CRNA

  • Certified Registered Nurse Anesthetist
  • Miami, OK
National Provider Identifier
1295712420
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
98467 Issued in OK
Practice address
200 2ND Ave SW
Miami, OK 74354-6830
Phone
(918) 540-7520
Fax
(918) 540-7533
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 98467 OK Primary
Certified Registered Nurse Anesthetist 367500000X 674661 TX

Addresses

Primary practice location

200 2ND Ave SW
Miami, OK 74354-6830

Mailing address

5300 N Independence Ave Ste 280
Oklahoma City, OK 73112-5555
Phone (918) 540-7520

Other identifiers 1

IdentifierTypeStateIssuer
166648902MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100827000491 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082697875 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Anesthesia Services, LLC 21 clinicians
Portland Anesthesia Services LLC 21 clinicians

Practice addresses (Care Compare)

5501 N Portland Ave
Oklahoma City, OK 73112-2074
Phone (405) 604-6000

Hospital & facility affiliations

  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
674661TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation CurrentSince Nov 17, 2019 Accepting new patients
Deaconess Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 15, 2023 Accepting new patients
Apex Anesthesia Consultants, PLLC Past Accepting new patients
Sundance Anesthesia PA Past Accepting new patients
Freeman Neosho Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

200 2nd Ave SW
Miami, OK 74354
Phone (918) 540-7113

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

5501 N Portland Ave
Oklahoma City, OK 73112
Phone (405) 604-6000

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

Interoperability endpoints

  • Direct secure messaging: jrichard29669@direct.integrisok.com

Organizations & group practices 6

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 4

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1295712420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE STE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125555",
            "telephone_number": "918-540-7520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 2ND AVE SW",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743546830",
            "telephone_number": "918-540-7520",
            "fax_number": "918-540-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "JEAN",
        "middle_name": "GABRIEL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "98467",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "674661",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166648902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.