Individual provider Active NPI

Jessica G Kosmowski, CRNA

  • Certified Registered Nurse Anesthetist
  • Macon, GA
National Provider Identifier
1578886941
Registry record updated Aug 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN170482 Issued in GA
Practice address
610 3Rd St
Suite 206
Macon, GA 31201-3294
Phone
(478) 464-2600
NPI assigned
Mar 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2013

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 RN170482 GA Primary

Addresses

Primary practice location

610 3Rd St
Suite 206
Macon, GA 31201-3294

Mailing address

101 Princeton Dr
Macon, GA 31220-8739
Phone (478) 737-0344

Other identifiers 3

IdentifierTypeStateIssuer
P00819053OtherGARAILROAD MEDICARE
580628385OtherGATRICARE
466646813AMedicaidGA

Other names 1

  • Ms. Jessica M Gilbert Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100505000019 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254469703 Reassigns benefits to 3 organizations

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
Robins Anesthesia Services LLCGroup PAC ID 1052207792, 26 clinicians

Practice addresses (Care Compare)

1120 Morningside Dr
Perry, GA 31069-2906
Phone (478) 987-3600

1601 Watson Blvd
Warner Robins, GA 31093-3431
Phone (478) 329-0051

1659 Watson Blvd
Warner Robins, GA 31093-3431
Phone (478) 329-3100

Hospital & facility affiliations

  • Emory Houston Hospital Warner Robins Hospital, Warner Robins, GA, CCN 110069

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Macon Gastroenterology Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 6, 2015 Accepting new patients
Anesthesia Associates of Macon LLP Past Accepting new patients
Henry Anesthesia Associates LLC Past Accepting new patients
Midstate Anesthesia, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2675 N Decatur Rd
Ste 506
Decatur, GA 30033
Phone (404) 299-1679

610 3rd St
Ste 102
Macon, GA 31201
Phone (478) 202-8691

610 3rd St
Ste 100
Macon, GA 31201
Phone (478) 745-8205

610 3rd St
Ste 206
Macon, GA 31201

1360 Caduceus Way
Bldg 300
Watkinsville, GA 30677
Phone (706) 850-4985

Organizations & group practices 6

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 2

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": "1268352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375747200000",
    "number": "1578886941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PRINCETON DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312208739",
            "telephone_number": "478-737-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 3RD ST",
            "address_2": "SUITE 206",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013294",
            "telephone_number": "478-464-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSMOWSKI",
        "first_name": "JESSICA",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-12",
        "last_updated": "2013-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN170482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00819053",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "580628385",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "466646813A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "GILBERT",
            "middle_name": "M",
            "prefix": "MS.",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; 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.