Individual provider Active NPI

Elizabeth Cluney Jenkins, CRNA

  • Certified Registered Nurse Anesthetist
  • Carrollton, KY
National Provider Identifier
1649645383
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3018044 Issued in KY
Practice address
309 11TH St
Carrollton, KY 41008-1435
Phone
(502) 662-0339
Fax
(502) 852-3762
NPI assigned
Dec 7, 2015
Last updated
May 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28245791C IN
Certified Registered Nurse Anesthetist 367500000X 3018044 KY Primary

Addresses

Primary practice location

309 11TH St
Carrollton, KY 41008-1435

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-0328

Other identifiers 2

IdentifierTypeStateIssuer
300018125MedicaidIN
7100562730MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180830001882 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315249323 Reassigns benefits to 2 organizations
I20230211000274 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315249323 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3920 Dutchmans LN
Louisville, KY 40207-4702
Phone (502) 852-5341

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28245791CINMDRegistered Nurse
3018044KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Norton - Kings Daughters Health Inc Nurse Anesthetist, Certified Registered CurrentSince Aug 20, 2018 Accepting new patients
Apollo Medical Group of Jeffersonville LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2021 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince May 1, 2023 Accepting new patients
Greater Louisville Anesthesia Services, PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2022 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
Norton - Kings Daughters Health Inc CurrentSince Aug 20, 2018 Accepting new patients
Tristate Pathology and Forensic Services LLC Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince May 1, 2023 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

2990 Gottbrath Pkwy
Jeffersonvlle, IN 47130
Phone (812) 670-0990

1373 N State Road 62
Madison, IN 47250
Phone (812) 801-0196

630 Broadway St
Madison, IN 47250
Phone (812) 265-0801

309 11th St
Carrollton, KY 41008
Phone (502) 732-3241

1025 New Moody Ln
Lagrange, KY 40031
Phone (502) 222-3335

3920 Dutchmans Ln
Louisville, KY 40207
Phone (502) 259-6000

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

Organizations & group practices 8

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 1

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": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1649645383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 11TH ST",
            "city": "CARROLLTON",
            "state": "KY",
            "postal_code": "410081435",
            "telephone_number": "502-662-0339",
            "fax_number": "502-852-3762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "ELIZABETH",
        "middle_name": "CLUNEY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-07",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28245791C",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3018044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300018125",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100562730",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.