Sandra J Jacobs, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP30004485 Issued in WA

Practice address

1600 N Main Ave
Lovington, NM 88260-2830

Phone

(575) 396-6611

Fax

(575) 396-1454

NPI assigned

Feb 8, 2006

Last updated

Nov 4, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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.

• BJSM Med Inc

  • Emergency Medicine Physician
  • Ronceverte, WV
  • NPI 1326037011
  NPD (past)
• Greenbrier Valley Emergency Physicians LLC

  • Emergency Medicine Physician
  • Ronceverte, WV
  • NPI 1760676407
  NPD (past)
• Mount Nittany Medical Center

  • Anesthesiology Physician
  • State College, PA
  • NPI 1528321015

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Physician Anesthesia Assoc Inc PS

  • Anesthesiology Physician
  • Yakima, WA
  • NPI 1457432791
  NPD (past)
• Premier Anesthesia of Fairmont, WV, a Division of Premier Anesthesia

  • Anesthesiology Physician
  • Fairmont, WV
  • NPI 1154595031

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Premier Anesthesia of Indiana PC

  • Anesthesiology Physician
  • Danville, IN
  • NPI 1982908737
  NPD (past)
• Providence Health & Service- Washington

  dba Providence Anesthesia Services

  • Anesthesiology Physician
  • Spokane, WA
  • NPI 1508118555
  NPD (past)
• Surgical Center Anesthesiologists

  • Anesthesiology Physician
  • Kirkland, WA
  • NPI 1912002528
  NPD (past)
• Surgical Center Anesthesiologists, PLLC

  • Anesthesiology Physician
  • Shoreline, WA
  • NPI 1861061731
  NPD (past)
• Wa Spok VH Crna LLC

  • Certified Registered Nurse Anesthetist
  • Spokane Valley, WA
  • NPI 1285884585

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1396718599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7711 NE 175TH ST",
            "address_2": "APT A302",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "980283567",
            "telephone_number": "425-274-5046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N MAIN AVE",
            "city": "LOVINGTON",
            "state": "NM",
            "postal_code": "882602830",
            "telephone_number": "575-396-6611",
            "fax_number": "575-396-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "SANDRA",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30004485",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "CRNA00524",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9612078",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL BLUE SHIELD",
            "identifier": "2701JA",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick J Homer, D.O.
• Pixie G Hopkins
• Ronald D Hopkins, D.O.
• Raniese A'Net Howard, LBSW
• Will Innocent, M.D
• Jerry H James, DDS
• Jla Senior Footcare NM LLC
• Jeffrey Paul Johnson, APN, FNP
• Rhoda R Jones, M.D., M.S.
• Bharath Reddy Karnati, M.D

• Certified Registered Nurse Anesthetist in Lovington, NM
• Providers in Lovington, NM by specialty
• Certified Registered Nurse Anesthetist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.