Active NPI
Jarrell Jeffrey, CRNA
- Certified Registered Nurse Anesthetist
- Edgewood, KY
National Provider Identifier
1366427718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 1054333
- Practice address
- 1 Medical Village Dr
Edgewood, KY 41017-3403 - Phone
- (859) 341-7246
- Fax
- (859) 341-7867
- NPI assigned
- Dec 8, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 1054333 | KY | Primary |
Addresses
Primary practice location
1 Medical Village Dr
Edgewood, KY 41017-3403
Mailing address
20 Medical Village Dr
Ste 258
Edgewood, KY 41017-5401
Phone (859) 341-7246
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000288569 | Other | ANTHEM BLUE SHIELD | |
| 2380776 | Medicaid | OH | |
| 74420647 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 93.01 of 100
- Quality
- 86.02
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1054333 | KY | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204156800000",
"number": "1366427718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 MEDICAL VILLAGE DR",
"address_2": "STE 258",
"city": "EDGEWOOD",
"state": "KY",
"postal_code": "410175401",
"telephone_number": "859-341-7246",
"fax_number": "859-341-7867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL VILLAGE DR",
"city": "EDGEWOOD",
"state": "KY",
"postal_code": "410173403",
"telephone_number": "859-341-7246",
"fax_number": "859-341-7867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEFFREY",
"first_name": "JARRELL",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-08",
"last_updated": "2008-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "KY",
"license": "1054333",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE SHIELD",
"identifier": "000000288569",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2380776",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "74420647",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Edgewood, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.