Individual provider Active NPI

Jessica Radford Phares, CRNA

  • Certified Registered Nurse Anesthetist
  • Raleigh, NC
National Provider Identifier
1447590534
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
91922 Issued in NC
Practice address
3400 Wake Forest Rd
Raleigh, NC 27609-7317
Phone
(919) 954-3765
NPI assigned
Feb 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 91922 LA
Certified Registered Nurse Anesthetist 367500000X 91922 NC Primary

Addresses

Primary practice location

3400 Wake Forest Rd
Raleigh, NC 27609-7317

Mailing address

3100 Spring Forest Rd
Suite130
Raleigh, NC 27616-2880
Phone (919) 873-9533

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130717000663 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507006475 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Practice addresses (Care Compare)

2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8114

Hospital & facility affiliations

  • Duke University Hospital Hospital, Durham, NC, CCN 340030
  • Wakemed, Cary Hospital Hospital, Cary, NC, CCN 340173

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
91922LAMDCertified Registered Nurse Anesthetist
91922NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Anesthesia, PLLC CurrentSince Jul 1, 2018 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince May 1, 2013 Accepting new patients
East Carolina Anesthesia Associates, PLLC Anesthesiology CurrentSince Sep 1, 2023 Accepting new patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Duke Health Integrated Practice, Inc CurrentSince Jul 1, 2023 Accepting new patients
Raleigh Sedation Associates LLC Anesthesiology CurrentSince Jul 11, 2023 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince May 1, 2013 Accepting new patients
University of Texas Health Science Center at Tyler-Facility-Physician Past Accepting new patients

Locations

1505 SW Cary Pkwy
Ste 202
Cary, NC 27511
Phone (919) 249-5087

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

2417 Atrium Dr
Ste 101
Raleigh, NC 27607
Phone (919) 249-5216

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

8300 Health Park
Ste 309
Raleigh, NC 27615
Phone (919) 571-1925

3400 Wake Forest Rd
Raleigh, NC 27609
Phone (919) 954-3000

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

Organizations & group practices 8

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 7

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": "1361836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1447590534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SPRING FOREST RD",
            "address_2": "SUITE130",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162880",
            "telephone_number": "919-873-9533",
            "fax_number": "919-873-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 WAKE FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097317",
            "telephone_number": "919-954-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHARES",
        "first_name": "JESSICA",
        "middle_name": "RADFORD",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-26",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "91922",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "91922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.