Individual provider Active NPI

Justin Patrick Yelverton, CRNA

  • Certified Registered Nurse Anesthetist
  • Leonardtown, MD
National Provider Identifier
1669015087
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AC002977 Issued in MD
Practice address
25500 Point Lookout Rd
Leonardtown, MD 20650-2015
Phone
(301) 475-8981
NPI assigned
Oct 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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 AC002977 MD Primary

Addresses

Primary practice location

25500 Point Lookout Rd
Leonardtown, MD 20650-2015

Mailing address

11663 Royal Lytham LN
Waldorf, MD 20602-5192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201204000319 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012343759 Reassigns benefits to 4 organizations
I20240131004921 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012343759 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Anesthesia of Ohio LLCGroup PAC ID 3779714258, 123 clinicians

Practice addresses (Care Compare)

6001 E Broad St
Columbus, OH 43213-1502
Phone (678) 690-7808

Hospital & facility affiliations

  • Mount Carmel East & West Hospital, Columbus, OH, CCN 360035

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Virginia PC CurrentSince Jun 1, 2021 Accepting new patients
American Anesthesiology of Virginia, PC CurrentSince Jun 1, 2021 Accepting new patients
Southwest Ohio Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 18, 2023 Accepting new patients
Premier Anesthesia of Ohio LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2024 Accepting new patients
Northstar Anesthesia of Virginia, LLC CurrentSince Jul 7, 2022 Accepting new patients

Locations

13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

793 W State St
Columbus, OH 43222
Phone (614) 234-1862

6001 E Broad St
Columbus, OH 43213
Phone (614) 224-6420

701 Tech Center Dr
Ste 100
Gahanna, OH 43230
Phone (440) 724-4498

5300 N Meadows Dr
Grove City, OH 43123
Phone (614) 234-4242

100 Medical Center Dr
Springfield, OH 45504
Phone (937) 523-1000

4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1669015087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11663 ROYAL LYTHAM LN",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206025192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25500 POINT LOOKOUT RD",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502015",
            "telephone_number": "301-475-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELVERTON",
        "first_name": "JUSTIN",
        "middle_name": "PATRICK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-18",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "AC002977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.