Individual provider Active NPI

Janith S Dehaven, CRNA

  • Certified Registered Nurse Anesthetist
  • Dothan, AL
National Provider Identifier
1336100270
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1026900 Issued in AL
Practice address
4370 W Main Street
Dothan, AL 36305
Phone
(334) 793-5000
Fax
(334) 615-8419
NPI assigned
Mar 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1026900 AL Primary

Addresses

Primary practice location

4370 W Main Street
Dothan, AL 36305

Mailing address

PO Box 6907
Dothan, AL 36302
Phone (334) 793-5000

Other identifiers 4

IdentifierTypeStateIssuer
03737502MedicaidMS
51515737OtherALBLUE CROSS BLUE SHIELD
P00055593OtherRR MEDICARE
1772445MedicaidLA

Other names 1

  • Janith S Pratt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180410000307 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062692007 Reassigns benefits to 2 organizations
I20210504000307 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062692007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1982
Medicare assignment
May accept Medicare assignment
Group practices
Valley Anesthesia PCGroup PAC ID 7416851597, 70 clinicians
Safe and Sound Anesthesia Services LLCGroup PAC ID 6204205412, 6 clinicians

Practice addresses (Care Compare)

1320 Maplewood Ave
Ronceverte, WV 24970-8016
Phone (304) 647-4411

1900 Electric Rd
Salem, VA 24153-7474
Phone (540) 772-3400

84 Brookshire LN
Beckley, WV 25801-6765
Phone (304) 255-2724

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1026900ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Camc Greenbrier Valley Medical Center Inc CurrentSince Jan 1, 2023 Accepting new patients
Valley Anesthesia PC CurrentSince May 1, 2021 Accepting new patients
Safe & Sound Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2024 Accepting new patients
Camc Greenbrier Valley Medical Center, Inc. CurrentSince Jan 1, 2023 Accepting new patients

Locations

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

84 Brookshire Ln
Beckley, WV 25801
Phone (304) 255-2341

1521 Maplewood Ave
Ronceverte, WV 24970

1320 Maplewood Ave
Ronceverte, WV 24970
Phone (304) 645-0870

Organizations & group practices 4

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.

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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336100270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6907",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36302",
            "telephone_number": "334-793-5000",
            "fax_number": "334-615-8419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 W MAIN STREET",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36305",
            "telephone_number": "334-793-5000",
            "fax_number": "334-615-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAVEN",
        "first_name": "JANITH",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1026900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03737502",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51515737",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00055593",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1772445",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANITH",
            "last_name": "PRATT",
            "middle_name": "S",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.