Roger Jacquelin, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

0001051476 Issued in VA

Practice address

125 Buena Vista Cir
South Hill, VA 23970-1431

Phone

(952) 442-9770

NPI assigned

Nov 17, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Memorial Hospital Hospital, South Hill, VA, CCN 490098

Merit-based Incentive Payment System (MIPS)

Final score

85.74 of 100Reported as group

Quality

74.5

Promoting interoperability

100

Improvement activities

40

Cost

77.96

Merit-based Incentive Payment System (MIPS)

Final score

83.95 of 100Reported as group

Quality

69.91

Promoting interoperability

99

Improvement activities

40

Cost

77.42

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• MCV Associated Physicians

  • Anesthesiology Physician
  • Richmond, VA
  • NPI 1710959457
  Medicare reassignment Care Compare group NPD
• CMH Physician Services, LLC

  • Internal Medicine Physician
  • South Hill, VA
  • NPI 1194760645

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Associated Anesthesia Providers Inc

  • Anesthesiology Physician
  • South Hill, VA
  • NPI 1881676617
  NPD Authorized official
• CMH Physician Services, LLC

  • Hospitalist Physician
  • South Hill, VA
  • NPI 1386028793
  NPD
• Community Memorial Hospital

  • Hospitalist Physician
  • South Hill, VA
  • NPI 1891014015
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Memorial Hospital

  • General Acute Care Hospital
  • South Hill, VA
  • NPI 1336103738
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1609858406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 10TH ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874552",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BUENA VISTA CIR",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239701431",
            "telephone_number": "952-442-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUELIN",
        "first_name": "ROGER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0001051476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF VA",
            "identifier": "080569",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hometown Orthodontics
• Keith Hummel, MD
• Sarah Moore Hutson, FNP
• Gail Inada, RPH
• Ismail Jolaoso, DDS, P.C.
• Priyanka R Jain
• Erin Robinson James
• Ousman Pen-Victoria Jassey
• Hamid Jibod
• John E Love Pharmacist LTD

• Certified Registered Nurse Anesthetist in South Hill, VA
• Providers in South Hill, VA by specialty
• Certified Registered Nurse Anesthetist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.