Individual provider Active NPI

Jason Edward Butler, CRNA

  • Certified Registered Nurse Anesthetist
  • Tulsa, OK
National Provider Identifier
1477528826
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
201464 Issued in OK
Practice address
6161 S Yale Ave
Tulsa, OK 74136-1902
Phone
(918) 494-0612
Fax
(918) 481-4170
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R090656 AR
Certified Registered Nurse Anesthetist 367500000X C002907 AR
Certified Registered Nurse Anesthetist 367500000X 201464 OK Primary

Addresses

Primary practice location

6161 S Yale Ave
Tulsa, OK 74136-1902

Mailing address

6839 S Canton Ave
Tulsa, OK 74136-3402
Phone (918) 494-0612

Other practice location 1

8805 S 12th St
Fort Smith, AR 72908-8897
Phone (478) 746-5644

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120425000662 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638171549 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renew Medical Group of Arkansas LTDGroup PAC ID 3173056298, 129 clinicians

Practice addresses (Care Compare)

7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone (479) 314-6000

Hospital & facility affiliations

  • Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R090656ARMDRegistered Nurse
C002907ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Medical Group of Arkansas LTD Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2024 Accepting new patients
Stacy R Tait PA CurrentSince Apr 1, 2025 Accepting new patients
Western Arkansas Obstetric Anesthesia LLC CurrentSince Jul 25, 2021 Accepting new patients
Premier Anesthesia of Arkansas Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince Apr 16, 2021 Accepting new patients
Arkansas Health Group CurrentSince Jan 6, 2021 Accepting new patients
Western Arkansas Anesthesiology Associates P.a. CurrentSince Jul 25, 2021 Accepting new patients
Arkansas Health Group CurrentSince Jan 6, 2021 Accepting new patients
Georgia Pain and Spine Solutions, PC Past Accepting new patients
Anesthesia Associates of Macon LLP Past Accepting new patients
Concordia Anesthesiology, Inc Past Accepting new patients
Rockdale Anesthesia Services, P.C. PastSince Mar 1, 2003 Accepting new patients
Oracle Anesthesia of Georgia LLC Nurse Anesthetist, Certified Registered PastSince Dec 13, 2011 Accepting new patients
Columbus Anesthesia Partners LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1000

6801 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-6000

1001 Towson Ave
Fort Smith, AR 72901
Phone (479) 441-3980

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

211 Crawford Memorial Dr
Van Buren, AR 72956
Phone (479) 471-4300

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18187/brand/1/csg/1/fhir/r4

Organizations & group practices 13

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.

View all 13

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1477528826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6839 S CANTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363402",
            "telephone_number": "918-494-0612",
            "fax_number": "918-481-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361902",
            "telephone_number": "918-494-0612",
            "fax_number": "918-481-4170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8805 S 12th St",
            "address_purpose": "LOCATION",
            "city": "Fort Smith",
            "state": "AR",
            "postal_code": "729088897",
            "country_code": "US",
            "telephone_number": "478-746-5644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JASON",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R090656",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C002907",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "201464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.