Jackie Harrison, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

019798 Issued in OH

Practice address

2213 Cherry St
Toledo, OH 43608-2603

Phone

(419) 251-4715

NPI assigned

Nov 12, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Ohio Anesthesia Consultants LLCGroup PAC ID 6901700640, 362 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112

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 and National Provider Directory roles.

• Southwest Ohio Anesthesia Consultants LLC

  • Anesthesiology Physician
  • Cincinnati, OH
  • NPI 1588645188

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Northstar Anesthesia of Ohio LLC

  • Anesthesiology Physician
  • Springfield, OH
  • NPI 1417276429
  Medicare reassignment NPD

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

• Mercy Health - St Vincent Medical Center LLC

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1467493551
  Care Compare affiliation

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1508334160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603",
            "telephone_number": "419-251-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "JACKIE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-12",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "313425",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "019798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harrison Homes, Inc.
• Joey Harrison-Williams
• Dajah Harrison
• Diann M Harrison, MA CCCA
• Emily Harrison
• Ketha Jerome Harrison Sr.
• Mary Harrison, CRNA
• Renee Harrison
• Tonisha Monique Harrison, NP-C
• Benjamin Randall Hart, M.D.

• Certified Registered Nurse Anesthetist in Toledo, OH
• Providers in Toledo, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.