Individual provider Active NPI

Marla R Haslam, CRNA

  • Certified Registered Nurse Anesthetist
  • Huntington, WV
National Provider Identifier
1689804130
Registry record updated Nov 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN264073 Issued in GA
Practice address
1340 Hal Greer Blvd
Huntington, WV 25701-3800
Phone
(304) 399-2960
NPI assigned
Jul 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2024

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 RN264073 GA Primary
Certified Registered Nurse Anesthetist 367500000X 66289 WV

Addresses

Primary practice location

1340 Hal Greer Blvd
Huntington, WV 25701-3800

Mailing address

PO Box 714960
Columbus, OH 43271-4960
Phone (888) 245-5525

Other names 1

  • Miss Marla R Jeter Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091201000214 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890834063 Reassigns benefits to 5 organizations
I20180219000368 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890834063 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of West Virginia PLLCGroup PAC ID 2668750241, 124 clinicians

Practice addresses (Care Compare)

1340 Hal Greer Blvd
Huntington, WV 25701-3804
Phone (304) 526-2000

Hospital & facility affiliations

  • Cabell Huntington Hospital, Inc Hospital, Huntington, WV, CCN 510055

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN264073GAMDCertified Registered Nurse Anesthetist
66289WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Cabell Huntington Hospital Inc Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2009 Accepting new patients
Cabell Huntington Hospital Inc CurrentSince Oct 10, 2009 Accepting new patients
Northstar Anesthesia of West Virginia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 12, 2016 Accepting new patients
Emory Specialty Associates, LLC CurrentSince Dec 18, 2024 Accepting new patients
Professional Anesthesia Service,Inc. CurrentSince Apr 27, 2020 Accepting new patients
The Emory Clinic Inc CurrentSince Dec 18, 2024 Accepting new patients

Locations

1364 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 712-7100

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

110 Roane St
Charleston, WV 25302
Phone (304) 344-0096

1340 Hal Greer Blvd
Huntington, WV 25701
Phone (304) 399-2960

2900 1st Ave
Huntington, WV 25702
Phone (304) 526-1111

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

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 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": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732320000000",
    "number": "1689804130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 714960",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432714960",
            "telephone_number": "888-245-5525",
            "fax_number": "717-653-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 HAL GREER BLVD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013800",
            "telephone_number": "304-399-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASLAM",
        "first_name": "MARLA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-17",
        "last_updated": "2024-11-23",
        "certification_date": "2024-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN264073",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "66289",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLA",
            "last_name": "JETER",
            "middle_name": "R",
            "prefix": "MISS",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2024; 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.