Jacqueline K Gividen, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

2020-04712 Issued in NC

Practice address

2080 W Arlington Blvd Ste B
Greenville, NC 27834-3770

Phone

(252) 752-2140

Fax

(252) 689-6502

NPI assigned

Feb 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 18

Medicare fee-for-service enrollment

Enrolled in NC, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Anesthesiology

Education

University of Louisville School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
• Sarasota Memorial Hospital - Venice Hospital, North Venice, FL, CCN 100359

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• SMH Physician Services Inc

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1346295292
  Medicare reassignment Care Compare group NPD
• East Carolina Anesthesia Associates, PLLC

  • Anesthesiology Physician
  • Greenville, NC
  • NPI 1205996519
  Medicare reassignment NPD
• One Anesthesia PLLC

  • Anesthesiology Physician
  • Louisville, KY
  • NPI 1174513246
  NPD
• One Anesthesia PLLC

  • Anesthesiology Physician
  • New Albany, IN
  • NPI 1316460595
  NPD (past)

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

• Sarasota County Public Hospital District

  • General Acute Care Hospital
  • North Venice, FL
  • NPI 1013534445
  Care Compare affiliation
• Sarasota County Public Hospital District

  • General Acute Care Hospital
  • Sarasota, FL
  • NPI 1245294826
  Care Compare affiliation

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1699740076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 W ARLINGTON BLVD STE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343770",
            "telephone_number": "252-752-2140",
            "fax_number": "252-689-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 W ARLINGTON BLVD STE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343770",
            "telephone_number": "252-752-2140",
            "fax_number": "252-689-6502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIVIDEN",
        "first_name": "JACQUELINE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01060188A",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2020-04712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDWISE HOOSIER ALLIANCE",
            "identifier": "200512950",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2684317000",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000361232",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "000000361232",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100082610",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA COMPREHENSIVE",
            "identifier": "000000361232",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000361232",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH SERVICES",
            "identifier": "200512950",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00265884",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "000000361232",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM SENIOR ADVANTAGE",
            "identifier": "000000361232",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE NATION BENEFIT",
            "identifier": "000000361232",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM MEDICAID",
            "identifier": "000000361232",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200512950",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50009617",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG PROGRAM",
            "identifier": "129703800",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "129703800",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE MEDICARE",
            "identifier": "134960H",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacey Hudson Gise, CRNA
• Katherine Huffstetler Gitzinger, CPNP
• Marisa Ann Giuliano, M.S.
• Kyle Given, DMD
• Gregg Givens, PH.D.
• Lana Perkins Gladden, M.S., CCC-SLP
• Erin Taylor Glaeser, CRNA
• Briana A Glaspy, RN
• Joel R Glassman, SLP
• Grace-Anna Marie Glenn

• Anesthesiology Physician in Greenville, NC
• Providers in Greenville, NC by specialty
• Anesthesiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.