Jesse B Johnson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

C001215 Issued in AR

Practice address

609 W Maple Ave
Springdale, AR 72764-5335

Phone

(479) 751-5711

Fax

(479) 751-1099

NPI assigned

Jul 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX, AR2 enrollments

Enrollment records 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premier Anesthesia of Arkansas Professional Corporation

  • Anesthesiology Physician
  • Fayetteville, AR
  • NPI 1932519485

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Northstar Anesthesia, PA

  • Anesthesiology Physician
  • Arlington, TX
  • NPI 1912978610

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Youngs Professional Services LLC

  dba YPS Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • New Iberia, LA
  • NPI 1922178599

  AR, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Chase Placek Floyd Meggers

  dba Northwest Anesthesiology Associates

  • Anesthesiology Physician
  • Rogers, AR
  • NPI 1326125113
  Medicare reassignment
• Capital Anesthesia Solutions of Arkansas, LLC

  • Anesthesiology Physician
  • Fayetteville, AR
  • NPI 1174125876

  Nurse Anesthetist, Certified Registered

  NPD
• Northeast Arkansas Clinic Charitable Foundation, Inc.

  dba NEA Baptist Clinic Anesthesia

  • Anesthesiology Physician
  • Jonesboro, AR
  • NPI 1992036032
  NPD (past)
• Mid-Louisiana Anesthesia Consultants, Apmc

  • Anesthesiology Physician
  • Alexandria, LA
  • NPI 1205888914
  NPD (past)

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1619975455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 583",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450583",
            "telephone_number": "800-475-6236",
            "fax_number": "903-787-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 W MAPLE AVE",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727645335",
            "telephone_number": "479-751-5711",
            "fax_number": "479-751-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JESSE",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "621415",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C001215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139829701",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "83751H",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "98519",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002959701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aileen Wolf Johnson, OTD, OTR/L
• Brooke Johnson, PHARMD
• Felicia Johnson, MD
• Heather Johnson, APRN
• Jason Johnson, MS, SPS
• Jessica Renee Johnson
• Lance Gregory Johnson, MHPP
• Lasheryl Johnson
• Leah Jennings Johnson, DMD
• Mary Elizabeth Johnson, MHPP

• Certified Registered Nurse Anesthetist in Springdale, AR
• Providers in Springdale, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.