Individual provider Active NPI

Angela D Jobe, CRNA

  • Certified Registered Nurse Anesthetist
  • Tulsa, OK
National Provider Identifier
1609148667
Registry record updated Apr 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
76231 Issued in OK
Practice address
6839 S Canton Ave
Tulsa, OK 74136-3402
Phone
(918) 494-0612
NPI assigned
Feb 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2022

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 76231 OK Primary

Addresses

Primary practice location

6839 S Canton Ave
Tulsa, OK 74136-3402

Mailing address

6839 S Canton Ave
Tulsa, OK 74136-3402
Phone (918) 494-0612

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120420000453 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911168711 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
Olympia Anesthesia PLCGroup PAC ID 5395767602, 13 clinicians

Practice addresses (Care Compare)

6901 S Olympia W Ave
Tulsa, OK 74132-1843
Phone (918) 388-5701

Hospital & facility affiliations

  • Tulsa Spine & Specialty Hospital Hospital, Tulsa, OK, CCN 370216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
76231OKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Osh Aai PLLC CurrentSince Jan 26, 2013 Accepting new patients
Olympia Anesthesia, PLC CurrentSince Jun 1, 2022 Accepting new patients

Locations

6839 S Canton Ave
Tulsa, OK 74136
Phone (918) 494-0612

6901 S Olympia Ave
Tulsa, OK 74132
Phone (918) 388-5701

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 and National Provider Directory roles.

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": "1328486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649548800000",
    "number": "1609148667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6839 S CANTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363402",
            "telephone_number": "918-494-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6839 S CANTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363402",
            "telephone_number": "918-494-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOBE",
        "first_name": "ANGELA",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-06",
        "last_updated": "2022-04-10",
        "certification_date": "2022-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "76231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

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

Verify at the official NPI Registry.