Individual provider Active NPI

Jennifer L Palk, CRNA

  • Certified Registered Nurse Anesthetist
  • Knoxville, TN
National Provider Identifier
1568741353
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
162674 Issued in TN
Practice address
501 20TH St
Suite 606
Knoxville, TN 37916-1863
Phone
(865) 546-8040
Fax
(865) 541-2787
NPI assigned
Aug 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 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 162674 TN Primary

Addresses

Primary practice location

501 20TH St
Suite 606
Knoxville, TN 37916-1863

Mailing address

501 20TH St
Suite 606
Knoxville, TN 37916-1863
Phone (865) 546-8040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150721002299 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 0244402071 Reassigns benefits to 1 organization
I20191024001317 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0244402071 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
Northern Anesthesia Providers PCGroup PAC ID 4789579863, 31 clinicians
US Anesthesia Partners of Florida IncGroup PAC ID 0345143152, 1,111 clinicians

Practice addresses (Care Compare)

416 Connable Ave
Petoskey, MI 49770-2212
Phone (231) 487-4000

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-5600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

Merit-based Incentive Payment System (MIPS)

Final score
80.53 of 100Reported as group
Quality
90
Improvement activities
20
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
162674TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Oct 2, 2019 Accepting new patients
Northern Anesthesia Providers PC CurrentSince Jun 22, 2015 Accepting new patients
Apollo Medical Group of Ocala LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2023 Accepting new patients
American Anesthesiology of Tennessee, P.C. Past Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

3241 SW 34th St
Ocala, FL 34474
Phone (352) 237-5906

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

801 N Orange Ave
Ste 630
Orlando, FL 32801
Phone (407) 650-0051

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

602 Jackson St
Petoskey, MI 49770
Phone (231) 348-2795

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1568741353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 20TH ST",
            "address_2": "SUITE 606",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161863",
            "telephone_number": "865-546-8040",
            "fax_number": "865-541-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 20TH ST",
            "address_2": "SUITE 606",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161863",
            "telephone_number": "865-546-8040",
            "fax_number": "865-541-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALK",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-10",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "162674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.