Jerry Wayne Davis, CRNA

Primary specialty

Critical Access HospitalTaxonomy code 282NC0060X

License

565508 Issued in TX

Practice address

2715 Avenue N
Nederland, TX 77627-7814

Phone

(409) 729-9339

NPI assigned

Jul 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Associates Group PLLCGroup PAC ID 2264792449, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Beaumont Hospital Hospital, Beaumont, TX, CCN 450346

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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.

• Anesthesia Associates Group PLLC

  • Anesthesiology Physician
  • Beaumont, TX
  • NPI 1477078202
  Medicare reassignment Care Compare group

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

• Baptist Hospitals of Southeast Texas

  dba Baptist Beaumont Hospital

  • General Acute Care Hospital
  • Beaumont, TX
  • NPI 1093744187
  Care Compare affiliation

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356357495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 AVENUE N",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776277814",
            "telephone_number": "409-729-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 AVENUE N",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776277814",
            "telephone_number": "409-729-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JERRY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "TX",
            "license": "565508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Critical Access Hospital in Nederland, TX
• Providers in Nederland, TX by specialty
• Critical Access Hospital in Texas

• 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.