Individual provider Active NPI

Jessica L Folsom, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Louis, MO
National Provider Identifier
1417400201
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2017002494 Issued in MO
Practice address
1 Barnes Jewish Hospital PLZ
Dept Anesthesiology
Saint Louis, MO 63110-1003
Phone
(800) 862-9980
Fax
(314) 362-1185
NPI assigned
Jul 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2017002494 MO Primary

Addresses

Primary practice location

1 Barnes Jewish Hospital PLZ
Dept Anesthesiology
Saint Louis, MO 63110-1003

Mailing address

PO Box 60352
Saint Louis, MO 63160-0352
Phone (800) 862-9980

Other identifiers 1

IdentifierTypeStateIssuer
910040034MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL, IN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20170213000681 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890078109 Reassigns benefits to 1 organization
I20180308000397 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890078109 Reassigns benefits to 2 organizations
I20191021001232 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890078109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
G and G Anesthesia LLCGroup PAC ID 4981912607, 92 clinicians

Practice addresses (Care Compare)

8 Doctors Park Rd
Mount Vernon, IL 62864-6224
Phone (618) 244-5500

Hospital & facility affiliations

  • Deaconess Illinois Crossroads Hospital, Mount Vernon, IL, CCN 140294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Anesthesia Providers S.C Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2017 Accepting new patients
G & G Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 12, 2025 Accepting new patients
Daviess County Hospital Current Accepting new patients
Daviess County Hospital Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2020 Accepting new patients
Millennium Anesthesiology Consultants, LLC CurrentSince Mar 1, 2018 Accepting new patients
Daviess County Hospital CurrentSince Sep 1, 2020 Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500

1402 Grand Ave
Washington, IN 47501
Phone (812) 254-2250

1314 E Walnut St
Washington, IN 47501
Phone (812) 254-2250

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1417400201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60352",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631600352",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ",
            "address_2": "DEPT ANESTHESIOLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLSOM",
        "first_name": "JESSICA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-27",
        "last_updated": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2017002494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "910040034",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Barnes Jewish Hospital Plz",
            "address_2": "Dept Anesthesiology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.