Jacquelyn Gump, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

COA.15833-NA Issued in OH

Practice address

5151 Reed Rd
Suite 225-C
Columbus, OH 43220-2595

Phone

(614) 975-4796

Fax

(614) 884-0776

NPI assigned

Feb 4, 2013

Sex

Female

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 3

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Management Associates LLCGroup PAC ID 3577902808, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital Hospital, Marysville, OH, CCN 360092

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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.

• Anesthesia Management Associates LLC

  • Anesthesiology Physician
  • Marysville, OH
  • NPI 1891566071
  Medicare reassignment Care Compare group NPD
• New Albany Orthopedic Anesthesia LLC

  • Anesthesiology Physician
  • Columbus, OH
  • NPI 1093762635
  Medicare reassignment NPD
• Deperro Plastic Surgery, LLC

  • Plastic Surgery Physician
  • Columbus, OH
  • NPI 1134573496
  NPD (past)
• Cape Cod Anesthesia Associates, Inc.

  • Anesthesiology Physician
  • Hyannis, MA
  • NPI 1659308021
  NPD (past)

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

• Memorial Hospital of Union County

  • General Acute Care Hospital
  • Marysville, OH
  • NPI 1720159338
  Care Compare affiliation

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1649519158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 REED RD",
            "address_2": "SUITE 225-C",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202595",
            "telephone_number": "614-975-4796",
            "fax_number": "614-884-0776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 REED RD",
            "address_2": "SUITE 225-C",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202595",
            "telephone_number": "614-975-4796",
            "fax_number": "614-884-0776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMP",
        "first_name": "JACQUELYN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-04",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.15833-NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01381010",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE COA LICENSE",
            "identifier": "COA.15833-NA",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0104362",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George James Gulu Sr., DDS
• John Hovannes Guluzian, DO
• Angela Marie Gum
• Nyima Gumaneh
• Richard L Gummer II, M.D.
• Maryrose Gumunyu
• Victoria Burris Gunawan, PA-C
• Yusuf Gunay, M.D.
• Adam W Gunckle, APRN-CRNA
• Sampath Gunda, MD

• Certified Registered Nurse Anesthetist in Columbus, OH
• Providers in Columbus, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.