Jack B Waters, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

201160004CRNA Issued in OR

Practice address

2365 E Segovia Dr
Saint George, UT 84790-7487

Phone

(435) 773-5585

NPI assigned

Feb 9, 2011

Last updated

Dec 20, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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 CA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comfort Anesthesia Associates IncGroup PAC ID 6002975489, 77 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.

• Comfort Anesthesia Associates Inc

  • Anesthesiology Physician
  • Bakersfield, CA
  • NPI 1043466550
  Medicare reassignment Care Compare group NPD
• Allied Anesthesia Medical Group Inc

  • Anesthesiology Physician
  • Orange, CA
  • NPI 1346267267
  Medicare reassignment NPD
• Tko Aesthesia

  • Clinic/Center
  • St George, UT
  • NPI 1386223683
  NPD Authorized official
• Central California Anesthesiology Solutions

  • Certified Registered Nurse Anesthetist
  • Madera, CA
  • NPI 1861020224
  Medicare reassignment
• St George Endoscopy Center LLC

  dba St. George Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • St George, UT
  • NPI 1457325573
  NPD (past)
• Digestive Disease Center-Green Valley LLC

  • Ambulatory Surgical Clinic/Center
  • Las Vegas, NV
  • NPI 1679706790
  NPD (past)
• Michael S. Schneider M.D., a Professional Corporation

  • Anesthesiology Physician
  • Irvine, CA
  • NPI 1285642306
  NPD (past)
• Pahrump Gastroenterology LLC

  • Specialist
  • Pahrump, NV
  • NPI 1164705547
  NPD (past)

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1407152358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 E SEGOVIA DR",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847907487",
            "telephone_number": "435-773-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 E SEGOVIA DR",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847907487",
            "telephone_number": "435-773-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "JACK",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-09",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "201160004CRNA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Washington County Court Support Services
• Washington County School District
• Washington County School District Preschool
• June E Washington
• Dylan Wasserman, DC
• Julianna Waters
• Gina Wathen
• Kirk Grant Watkins, MD
• Caitlin Watson
• Dustin Rideout Watson, MD

• Certified Registered Nurse Anesthetist in St George, UT
• Providers in St George, UT by specialty
• Certified Registered Nurse Anesthetist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.