Individual provider Active NPI

Charles Jason Calhoun, CRNA

  • Certified Registered Nurse Anesthetist
  • Davenport, FL
National Provider Identifier
1558649095
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9213832 Issued in FL
Practice address
40100 Highway 27
Davenport, FL 33837-5906
Phone
(863) 422-4971
NPI assigned
Aug 2, 2011
Last updated
Aug 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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 ARNP9213832 FL Primary

Addresses

Primary practice location

40100 Highway 27
Davenport, FL 33837-5906

Mailing address

8390 Champions Gate Blvd
Suite 306
Champions Gate, FL 33896-8310
Phone (407) 390-1677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111024000615 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224201090 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams National LLCGroup PAC ID 3870813025, 310 clinicians

Practice addresses (Care Compare)

40100 Hwy 27
Davenport, FL 33837-5906
Phone (863) 866-4192

6002 Berryhill Rd
Milton, FL 32570-5062
Phone (850) 626-7762

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9213832FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North Tampa Anesthesia Consultants CurrentSince Aug 10, 2011 Accepting new patients
Ams National LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 12, 2019 Accepting new patients

Locations

40100 Highway 27
Davenport, FL 33837
Phone (863) 419-2496

2222 S Harbor City Blvd
Ste 540
Melbourne, FL 32901
Phone (321) 541-1776

6002 Berryhill Rd
Milton, FL 32570
Phone (850) 474-8688

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

10461 Quality Dr
Spring Hill, FL 34609
Phone (352) 688-3002

1402 W Fletcher Ave
Tampa, FL 33612
Phone (813) 627-4723

15520 W Colonial Dr
Winter Garden, FL 34787
Phone (321) 277-2375

6733 Gall Blvd
Zephyrhills, FL 33542
Phone (813) 783-8242

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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 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": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1558649095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8390 CHAMPIONS GATE BLVD",
            "address_2": "SUITE 306",
            "city": "CHAMPIONS GATE",
            "state": "FL",
            "postal_code": "338968310",
            "telephone_number": "407-390-1677",
            "fax_number": "407-390-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40100 HIGHWAY 27",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375906",
            "telephone_number": "863-422-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALHOUN",
        "first_name": "CHARLES",
        "middle_name": "JASON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-02",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9213832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; 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.