Individual provider Active NPI

John K Prescott, CRNA

  • Certified Registered Nurse Anesthetist
  • Craig, CO
National Provider Identifier
1619997327
Registry record updated Nov 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R1592685 Issued in MN
Practice address
750 Hospital Loop
Craig, CO 81625-8750
Phone
(970) 824-1088
NPI assigned
Jul 19, 2006
Last updated
Nov 6, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2017

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 R1592685 MN Primary

Addresses

Primary practice location

750 Hospital Loop
Craig, CO 81625-8750

Mailing address

PO Box 1648
Craig, CO 81626-1648
Phone (918) 850-5607

Other identifiers 2

IdentifierTypeStateIssuer
22978241MedicaidCO
010672601002OtherOKBCBSOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121022000278 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365446325 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1592685MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Craig Anesthesia Services LLC Current Accepting new patients
Eastern Rio Blanco County Health Service District CurrentSince Oct 21, 2023 Accepting new patients
Eastern Rio Blanco County Health Service District Current Accepting new patients
Eastern Rio Blanco County Health Service District CurrentSince Oct 21, 2023 Accepting new patients
Mountain Valley Anesthesia Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

651 Yampa Ave
Craig, CO 81625
Phone (970) 824-1020

750 Hospital Loop
Craig, CO 81625
Phone (970) 824-9411

100 Pmc Dr
Meeker, CO 81641
Phone (970) 878-4014

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

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509926400000",
    "number": "1619997327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1648",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816261648",
            "telephone_number": "918-850-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 HOSPITAL LOOP",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816258750",
            "telephone_number": "970-824-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESCOTT",
        "first_name": "JOHN",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2017-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R1592685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22978241",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSOK",
            "identifier": "010672601002",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Craig, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2017; 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.