Jackie E Erb

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

101285 Issued in NE

Practice address

910 20TH St
Gothenburg, NE 69138-1237

Phone

(308) 537-3661

NPI assigned

Sep 28, 2012

Last updated

Jan 29, 2015By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Platte Surgery Center Anesthesia LLCGroup PAC ID 6709969751, 20 clinicians

Gothenburg Memorial HospitalGroup PAC ID 6709832983, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• North Platte Surgery Center Anesthesia, LLC

  • Anesthesiology Physician
  • North Platte, NE
  • NPI 1780869222

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Gothenburg Memorial Hospital

  dba Gothenburg Health

  • Critical Access Hospital
  • Gothenburg, NE
  • NPI 1922051531
  Medicare reassignment Care Compare group
• North Platte Nebraska Hospital Corporation

  dba Great Plains Health

  • General Acute Care Hospital
  • North Platte, NE
  • NPI 1700855533
  Medicare reassignment NPD
• North Platte Nebraska Hospital Corporation

  dba Great Plains Health

  • Medical Oncology Physician
  • North Platte, NE
  • NPI 1134355332
  NPD
• North Platte Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • North Platte, NE
  • NPI 1154316339
  NPD

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1396096400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 21ST ST",
            "city": "GOTHENBURG",
            "state": "NE",
            "postal_code": "691382501",
            "telephone_number": "402-318-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 20TH ST",
            "city": "GOTHENBURG",
            "state": "NE",
            "postal_code": "691381237",
            "telephone_number": "308-537-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERB",
        "first_name": "JACKIE",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-28",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "101285",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": "201242161RN",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "69233",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Hult, M.D., P.C.
• Carson Lee Davis
• Kandace Davis, PT
• Colby Thomas Delatour, P.T.A.
• Lacy J Dye, LIMHP
• Family and Sport Medicine, PC
• Robyn Favinger
• Erin Feather, M.S. CCC-SLP
• Cynthia Ann Foresman, LMHP
• Kyle Ryan Fornoff, DPT

• Certified Registered Nurse Anesthetist in Gothenburg, NE
• Providers in Gothenburg, NE by specialty
• Certified Registered Nurse Anesthetist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; 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.