Individual provider Active NPI

Jacob Kessen, CRNA

  • Certified Registered Nurse Anesthetist
  • Kansas City, KS
National Provider Identifier
1326552282
Registry record updated May 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
43-557576-122 Issued in KS
Practice address
3901 Rainbow Blvd
Kansas City, KS 66160-8500
Phone
(913) 588-5000
NPI assigned
Nov 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 252662 GA
Registered Nurse 163W00000X 14-142778-122 KS
Certified Registered Nurse Anesthetist 367500000X 155909 KS
Certified Registered Nurse Anesthetist 367500000X 43-557576-122 KS Primary

Addresses

Primary practice location

3901 Rainbow Blvd
Kansas City, KS 66160-8500

Mailing address

12117 W 99TH St
Lenexa, KS 66215-1660

Other identifiers 1

IdentifierTypeStateIssuer
1326552282MedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, AZ, GA, TX, OK5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20180529002049 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658636485 Reassigns benefits to 1 organization
I20210325002103 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658636485 Reassigns benefits to 1 organization
I20220707000063 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658636485 Reassigns benefits to 3 organizations
I20250808000442 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658636485 Reassigns benefits to 1 organization
I20260610001529 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658636485 Reassigns benefits to 1 organization

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
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Practice addresses (Care Compare)

10512 N 110TH E Ave
Bailey Med Ctr
Owasso, OK 74055-6636
Phone (918) 376-8000

11937 US Hwy 271
Tyler, TX 75708-3154
Phone (903) 877-7000

14101 Pkwy Commons Dr
Oklahoma City, OK 73134-6012
Phone (405) 749-2700

7400 Barlite Blvd
San Antonio, TX 78224-1308
Phone (210) 921-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
252662GAMDRegistered Nurse
14-142778-122KSMDRegistered Nurse
155909KSMDCertified Registered Nurse Anesthetist
43-557576-122KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mak Anesthesia Holdings LLC CurrentSince May 1, 2022 Accepting new patients
Anesthesia Partners & Management LLC Nurse Anesthetist, Certified Registered CurrentSince May 10, 2021 Accepting new patients
Mak Anesthesia Georgia, LLC CurrentSince Dec 23, 2022 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2025 Accepting new patients
Fortis Health, LLC CurrentSince Apr 1, 2024 Accepting new patients

Locations (25 of 28)

1020 N San Francisco St
Ste 100
Flagstaff, AZ 86001
Phone (928) 774-2300

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

7301 N 16th St
Ste 102
Phoenix, AZ 85020
Phone (602) 772-8600

3900 E Camelback Rd
Ste 190
Phoenix, AZ 85018
Phone (888) 724-6236

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

3110 Clearwater Dr
Prescott, AZ 86305
Phone (623) 241-6185

1704 W Anklam Rd
Ste 108
Tucson, AZ 85745
Phone (623) 241-6185

2041 Mesa Valley Way
Ste 125
Austell, GA 30106
Phone (678) 309-8100

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1266 Highway 515 S
Jasper, GA 30143
Phone (706) 301-5350

1300 Ridenour Blvd NW
Ste 300
Kennesaw, GA 30152
Phone (770) 693-0810

780 Canton Rd NE
Ste 100250
Marietta, GA 30060
Phone (770) 422-1579

895 Canton Rd NE
Bldg 200
Marietta, GA 30060
Phone (678) 784-0203

2550 Windy Hill Rd SE
Ste 218
Marietta, GA 30067
Phone (770) 933-1900

4500 Hospital Blvd
Ste 210
Roswell, GA 30076

3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500

5995 Barfield Rd
Sandy Springs, GA 30328
Phone (404) 256-1507

1100 Johnson Fy Rd NE
Ste 130
Sandy Springs, GA 30342
Phone (404) 531-9988

4441 Atlanta Rd SE
Ste 312
Smyrna, GA 30080
Phone (470) 956-4200

2131 Fountain Dr
Snellville, GA 30078
Phone (770) 736-2225

2306 Wisteria Dr
Ste 100
Snellville, GA 30078
Phone (770) 979-8200

6001 SW 6th Ave
Ste 100
Topeka, KS 66615
Phone (785) 272-8807

14425 Falcon Head Blvd
#11
Austin, TX 78738
Phone (512) 900-1006

3080 College St
#T
Beaumont, TX 77701
Phone (409) 212-5002

6949 Bryant Irvin Rd
Ste 110
Ft Worth, TX 76132
Phone (817) 332-1818

Interoperability endpoints

  • Direct secure messaging: jkessen536350@direct-ehr-ssmhc.com

Organizations & group practices 5

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 1

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": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525996800000",
    "number": "1326552282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12117 W 99TH ST",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662151660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "913-588-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESSEN",
        "first_name": "JACOB",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-29",
        "last_updated": "2018-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "252662",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "14-142778-122",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "155909",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "43-557576-122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326552282",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.