Fredena Lucas Jaggers, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

004545 Issued in NC

Practice address

2170 Midland Rd
Southern Pines, NC 28387-2927

Phone

(910) 295-1221

NPI assigned

Sep 20, 2006

Last updated

Mar 5, 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 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Medical University of South Carolina College of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Salem Professional Anesthesia Services PCGroup PAC ID 9133180326, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://35e809af-55fd-4464-b97b-98cb80ebf600.gastro.prod.fhir.ema-api.com/fhir/r4/

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.

• Salem Professional Anesthesia Services PC

  • Certified Registered Nurse Anesthetist
  • Greensboro, NC
  • NPI 1538171897

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Carolina Anesthesia Associates PA

  • Anesthesiology Physician
  • Statesville, NC
  • NPI 1699723791

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Carolina Regional Anesthesia PLLC

  • Certified Registered Nurse Anesthetist
  • Pinehurst, NC
  • NPI 1891072609

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Nurse Anesthesia of North Carolina, PLLC

  • Certified Registered Nurse Anesthetist
  • Elizabeth City, NC
  • NPI 1689628729

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesia Care Services, PA

  • Certified Registered Nurse Anesthetist
  • Forest, VA
  • NPI 1609833474

  NC, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Salem Professional Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • Advance, NC
  • NPI 1992044564

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Western Carolina Digestive Consultants PA

  • Gastroenterology Physician
  • Sylva, NC
  • NPI 1790870830
  NPD (past)
• Western Carolina Endoscopy Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Franklin, NC
  • NPI 1225225592
  NPD (past)
• New Mexico Anesthesia Specialists LLC

  • Certified Registered Nurse Anesthetist
  • Alamogordo, NM
  • NPI 1629390083

  Nurse Anesthetist, Certified Registered

  NPD (past)
• North American Partners in Anesthesia (Virginia), LLC

  • Anesthesiology Physician
  • Fairfax, VA
  • NPI 1922031442
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1336246289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 PEACHTREE LN STE B",
            "city": "ADVANCE",
            "state": "NC",
            "postal_code": "270066783",
            "telephone_number": "336-624-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 MIDLAND RD",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283872927",
            "telephone_number": "910-295-1221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "128 Peachtree Ln Ste B",
            "address_purpose": "LOCATION",
            "city": "Advance",
            "state": "NC",
            "postal_code": "270066783",
            "country_code": "US",
            "telephone_number": "337-212-9144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAGGERS",
        "first_name": "FREDENA",
        "middle_name": "LUCAS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "004545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HRH RR CRNA",
            "identifier": "430056454",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SCH RR CRNA",
            "identifier": "430079566",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8000180",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8000315",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CRNA PRO.",
            "identifier": "8051710",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "170062",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy S. Ivey, C.P.N.P.
• Amanda R Jackson, BCAT
• Heather Jackson, LBMT
• Laura Permelia Jackson, M.S.ED.,ATC, LAT
• Nicole Jacobs, MD
• Thomas Scott Jamison, MD
• Jeffrey S. Almony, MD, DDS, PA (Southern Pines Oral & Maxillofacial Surgery Center)
• Jody McCain, PSYD PLLC
• Lindsay Johannes-Monroe, PH.D.
• John F. Ceraso, DMD, P.a.

• Certified Registered Nurse Anesthetist in Southern Pines, NC
• Providers in Southern Pines, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.