Active NPI
Jeremy Linden
- Certified Registered Nurse Anesthetist
- Travis AFB, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 200241389RN
- Practice address
- 101 Bodin Cir
Travis AFB, CA 94535-1809 - Phone
- (707) 423-7611
- NPI assigned
- Jun 11, 2008
- Last updated
- May 9, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 1070486 | TX | |
| Certified Registered Nurse Anesthetist | 367500000X | 200241389RN | OR | Primary |
Addresses
Primary practice location
101 Bodin Cir
Travis AFB, CA 94535-1809
Mailing address
101 Bodin Cir
Travis AFB, CA 94535-1809
Other practice location 1
719 W Coke Rd
Winnsboro, TX 75494-3011
Phone (903) 342-5227
Other practice location 2
115 Airport Rd
Sulphur Springs, TX 75482-2105
Phone (903) 885-7671
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | Northwest Permanente PC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
105 -II Medical PLZ
Christus Trinity Clinic
Sulphur Springs, TX 75482-2105
Phone (903) 885-5439
115 Airport Rd
Sulphur Springs, TX 75482-2105
Phone (903) 885-7671
620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900
630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560
719 W Coke Rd
Christus Trinity Clinic
Winnsboro, TX 75494-3011
Phone (903) 342-5227
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Mother Frances Hospital-Winnsboro | Current | Accepting new patients | |
| Mother Frances Hospital-Winnsboro | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Mother Frances Hospital Winnsboro | Past | Accepting new patients |
Locations
115 Airport Rd
Sulphur Springs, TX 75482
Phone (903) 885-7671
630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888
719 W Coke Rd
Winnsboro, TX 75494
Phone (903) 342-3710
719 W Coke Rd
Ste 4
Winnsboro, TX 75494
Phone (903) 342-3760
Organizations & group practices 5
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.
-
dba Christus Trinity Clinic
- Family Medicine Physician
- Tyler, TX
- NPI 1285684225
-
- Family Medicine Physician
- Winnsboro, TX
- NPI 1598091555
-
dba Christus Trinity Clinic
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1801673165
-
- Critical Access Hospital
- Winnsboro, TX
- NPI 1659308948
-
dba Mother Frances Hospital Winnsboro Rural Health Clinic
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1922294867
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Christus Mother Frances - Sulphur Springs
- General Acute Care Hospital
- Sulphur Springs, TX
- NPI 1033568621
-
dba Christus Mother Frances Hospital Tyler
- General Acute Care Hospital
- Tyler, TX
- NPI 1679578439
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652054400000",
"number": "1558521716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 BODIN CIR",
"city": "TRAVIS AFB",
"state": "CA",
"postal_code": "945351809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BODIN CIR",
"city": "TRAVIS AFB",
"state": "CA",
"postal_code": "945351809",
"telephone_number": "707-423-7611"
}
],
"practiceLocations": [
{
"address_1": "719 W Coke Rd",
"address_purpose": "LOCATION",
"city": "Winnsboro",
"state": "TX",
"postal_code": "754943011",
"country_code": "US",
"telephone_number": "903-342-5227",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "115 Airport Rd",
"address_purpose": "LOCATION",
"city": "Sulphur Springs",
"state": "TX",
"postal_code": "754822105",
"country_code": "US",
"telephone_number": "903-885-7671",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LINDEN",
"first_name": "JEREMY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-11",
"last_updated": "2022-05-09",
"certification_date": "2022-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "1070486",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OR",
"license": "200241389RN",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Northwest Permanente PC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "10180 SE Sunnyside Rd",
"city": "Clackamas",
"state": "OR",
"country_code": "US",
"postal_code": "970158970",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Travis AFB, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; 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.