Individual provider Active NPI

Hailey Brooke Weavers, CRNA

  • Certified Registered Nurse Anesthetist
  • Jonesboro, AR
National Provider Identifier
1639942881
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
226452 Issued in AR
Practice address
4800 E Johnson Ave
Jonesboro, AR 72405-8413
Phone
(870) 936-1000
NPI assigned
Oct 31, 2023
Last updated
Oct 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 226452 AR Primary
Certified Registered Nurse Anesthetist 367500000X 2025032061 MO

Addresses

Primary practice location

4800 E Johnson Ave
Jonesboro, AR 72405-8413

Mailing address

1050 W 10TH St
Rolla, MO 65401-2905
Phone (573) 458-8899

Other practice location 1

1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 458-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240312001078 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507202694 Reassigns benefits to 1 organization
I20250923000582 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507202694 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelinc Anesthesia V, P.a.Group PAC ID 8921359712, 41 clinicians

Practice addresses (Care Compare)

1000 W 10TH St
Rolla, MO 65401-2905
Phone (573) 458-8899

4800 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025032061MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelinc Anesthesia V, P.a. Nurse Anesthetist, Certified Registered CurrentSince Feb 6, 2024 Accepting new patients
Phelps County Regional Medical Center CurrentSince Oct 1, 2025 Accepting new patients
Phelps County Regional Medical Center CurrentSince Oct 1, 2025 Accepting new patients

Locations

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

1050 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

3340 Players Club Pkwy
Ste 350
Memphis, TN 38125
Phone (901) 207-2017

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1698710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1639942881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-458-8899",
            "fax_number": "573-341-5611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 E JOHNSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724058413",
            "telephone_number": "870-936-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654012905",
            "country_code": "US",
            "telephone_number": "573-458-8899",
            "fax_number": "573-341-5611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEAVERS",
        "first_name": "HAILEY",
        "middle_name": "BROOKE",
        "name_prefix": "Miss",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-31",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "226452",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2025032061",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; 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.