Jennifer Elizabeth Vicknair, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP04334 Issued in LA

Practice address

778 Scogin Dr
Monticello, AR 71655-5729

Phone

(870) 367-2411

NPI assigned

Jul 12, 2006

Last updated

Jan 6, 2024By the provider in NPPES

Sex

Female

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 LA, AR2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rural Health Pain Management LLCGroup PAC ID 8921410341, 35 clinicians

Willis Knighton Medical Center Inc Crna GroupGroup PAC ID 1759358674, 93 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111
• Forrest City Medical Center Hospital, Forrest City, AR, CCN 040019

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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.

• Rural Health Pain Management LLC

  • Pain Medicine (Anesthesiology) Physician
  • Forrest City, AR
  • NPI 1265039556
  Medicare reassignment Care Compare group NPD
• Willis Knighton Medical Center Inc. Crna Group

  dba Willis Knighton Anesthesia Services

  • Anesthesiology Physician
  • Shreveport, LA
  • NPI 1174546097

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Arkansas Health Group

  dba Arkansas Health Group Anesthesia

  • Anesthesiology Physician
  • Little Rock, AR
  • NPI 1508800962
  Medicare reassignment NPD
• Endoscopy Center of Monroe

  • Ambulatory Surgical Clinic/Center
  • Monroe, LA
  • NPI 1417957796
  Medicare reassignment NPD
• Franklin Parish Hospital Service Dist 1

  dba Franklin Medical Center

  • Rural Acute Care Hospital
  • Winnsboro, LA
  • NPI 1619143120
  Medicare reassignment NPD
• Medical Center Anesthesiologists

  • Anesthesiology Physician
  • Shreveport, LA
  • NPI 1669469748
  Medicare reassignment NPD
• Richland Parish Hospital Service District No 1-B

  dba Richardson Medical Center

  • General Acute Care Hospital
  • Rayville, LA
  • NPI 1255370144
  Medicare reassignment NPD
• Shreveport Sedation Associates LLC

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
  • NPI 1770083164

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Youngs Professional Services LLC

  dba YPS Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • New Iberia, LA
  • NPI 1922178599

  AR, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Christus Health Northern Louisiana

  dba Christus Shreveport-Bossier Health System

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
  • NPI 1801822762
  Medicare reassignment
• Arkansas Health Group

  dba Baptist Health Surgical Clinic-Stuttgart

  • Surgery Physician
  • Stuttgart, AR
  • NPI 1952840555
  NPD
• Capital Anesthesia Solutions of Arkansas, LLC

  • Anesthesiology Physician
  • Fayetteville, AR
  • NPI 1174125876

  Nurse Anesthetist, Certified Registered

  NPD

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

• Forrest City Arkansas Hospital Company LLC

  dba Forrest City Medical Center

  • General Acute Care Hospital
  • Forrest City, AR
  • NPI 1811912009
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Bossier Health Center

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba Willis Knighton South Hospital

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Pierremont Health Center

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704499200000",
    "number": "1306861398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 FIDDLERS CREEK DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712911774",
            "telephone_number": "318-381-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "778 SCOGIN DR",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716555729",
            "telephone_number": "870-367-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKNAIR",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2024-01-06",
        "certification_date": "2024-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP04334",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN087113",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C003168",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1179272",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juanita B Turner, LMSW
• Lindsey Ray Tyson, PT
• University of Arkansas at Monticello (UAM Sports Medicine)
• Vera Lloyd Presbyterian Family Services, Inc.
• Emily Vickers, COTA
• Amanda Vincent
• Walgreen Co (Walgreens #10666)
• Karen Sue Walker, LCSW
• Walmart Inc. (Walmart Pharmacy 10-0348)
• Stephanie Walton, QBHP

• Certified Registered Nurse Anesthetist in Monticello, AR
• Providers in Monticello, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2024; 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.