Individual provider Active NPI

Jacquelyn McDonald, RN

  • Certified Registered Nurse Anesthetist
  • Birmingham, AL
National Provider Identifier
1417605676
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-124874 Issued in AL
Practice address
619 19TH St S
Birmingham, AL 35249-2280
Phone
(205) 934-4011
NPI assigned
Mar 16, 2022
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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 1-124874 AL Primary

Addresses

Primary practice location

619 19TH St S
Birmingham, AL 35249-2280

Mailing address

PO Box 55310
Birmingham, AL 35255-5310
Phone (205) 731-9701

Other practice location 1

2655 Northwinds Pkwy
Alpharetta, GA 30009-2280
Phone (770) 643-5619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220526002551 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709264096 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montgomery Anesthesia Associates, PCGroup PAC ID 9537153572, 51 clinicians
Premier Anesthesia of Montgomery PCGroup PAC ID 5799684148, 117 clinicians

Practice addresses (Care Compare)

1725 Pine St
Montgomery, AL 36106-1109
Phone (334) 513-1173

2105 E S Blvd
Montgomery, AL 36116-2409
Phone (334) 286-3579

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-124874ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery Anesthesia Associates, PC Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2025 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Aug 1, 2025 Accepting new patients
Premier Anesthesia of Montgomery PC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2022 Accepting new patients
Flowers HB Medical Services LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 12, 2025 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

1725 Park Pl
Montgomery, AL 36106
Phone (334) 293-8484

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842

2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1417605676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55310",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352555310",
            "telephone_number": "205-731-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352492280",
            "telephone_number": "205-934-4011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2655 Northwinds Pkwy",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300092280",
            "country_code": "US",
            "telephone_number": "770-643-5619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "JACQUELYN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-16",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-124874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.