Individual provider Active NPI

Jennifer Faircloth, CRNA

  • Certified Registered Nurse Anesthetist
  • Wilmington, NC
National Provider Identifier
1710210273
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
159820 Issued in NC
Practice address
2511 Delaney Ave
Wilmington, NC 28403-6003
Phone
(910) 667-9328
NPI assigned
Sep 15, 2009
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4029912 KY
Certified Registered Nurse Anesthetist 367500000X 159820 NC Primary
Certified Registered Nurse Anesthetist 367500000X AP61525326 WA

Addresses

Primary practice location

2511 Delaney Ave
Wilmington, NC 28403-6003

Mailing address

PO Box 40908
Fayetteville, NC 28309-0908
Phone (910) 615-6448

Other practice location 1

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-5132

Other practice location 2

101 W 8th Ave
Spokane, WA 99204-2307
Phone (509) 474-3131

Other practice location 3

800 Rose St
Lexington, KY 40536-6003
Phone (859) 323-5956

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jfaircloth134828@direct.nhrmc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC, FL, ME, MO, AZ, KY, GA, MI9 enrollments

Enrollment records 9

Enrollment IDStateProvider typePAC IDDetails
I20091023000647 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153468186 Reassigns benefits to 3 organizations
I20191115000249 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153468186
I20220105002905 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153468186 Reassigns benefits to 5 organizations
I20220617001507 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153468186 Reassigns benefits to 1 organization
I20230223001927 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153468186 Reassigns benefits to 1 organization
I20231018001766 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153468186 Reassigns benefits to 1 organization
I20250505002848 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153468186 Reassigns benefits to 1 organization
I20251110001631 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153468186 Reassigns benefits to 2 organizations
I20260528002388 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153468186 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
Munson Medical GroupGroup PAC ID 8820277015, 191 clinicians
University of KentuckyGroup PAC ID 3072425289, 778 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

800 Rose St
Lexington, KY 40536-7001
Phone (859) 257-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4029912KYMDCertified Registered Nurse Anesthetist
159820NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Current Accepting new patients
Gi Anesthesia of Georgia LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2025 Accepting new patients
Apollo Medical Group of Ocala LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 18, 2024 Accepting new patients
Baycare Medical Group, Inc CurrentSince Jan 1, 2025 Accepting new patients
SE Georgia Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2025 Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2022 Accepting new patients
Greater Florida Anesthesiologists, LLC Current Accepting new patients
Sampson Regional Medical Services, LLC Current Accepting new patients
Brevard Physician Associates, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2022 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 28, 2017 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Greater Florida Anesthesiologists, LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2024 Accepting new patients
Coastal Ambulatory Anesthesia LLC CurrentSince Dec 1, 2025 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2021 Accepting new patients
Greater Florida Anesthesiologists, LLC CurrentSince May 1, 2024 Accepting new patients
University of Kentucky CurrentSince Apr 30, 2025 Accepting new patients
Sampson Regional Medical Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 11, 2017 Accepting new patients
Ozark Anesthesia Associates, Inc. CurrentSince Apr 18, 2023 Accepting new patients
Antigua Anesthesia Management, LLC CurrentSince Dec 5, 2023 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC CurrentSince Feb 1, 2021 Accepting new patients
Kennebec Anesthesia Associates, P.a. CurrentSince May 23, 2022 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC PastSince Aug 25, 2019 Accepting new patients

Locations (25 of 31)

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

2735 Silver Creek Rd
Bullhead City, AZ 86442
Phone (520) 763-2273

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

2140 W 68th St
Hialeah, FL 33016
Phone (305) 332-2065

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

3241 SW 34th St
Ocala, FL 34474
Phone (352) 237-5906

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

460 N State Road 7
Royal Palm Beach, FL 33411
Phone (561) 792-7333

900 Carillon Pkwy
Ste 205
St Petersburg, FL 33716
Phone (727) 561-2710

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

2600 Bruce B Downs Blvd
Zephyrhills, FL 33544
Phone (954) 393-5000

7050 Gall Blvd
Zephyrhills, FL 33541
Phone (813) 779-1209

1955 Textile Way
Gainesville, GA 30501
Phone (678) 987-1499

1139 Lexington Ave
Savannah, GA 31404
Phone (912) 303-4200

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

35 Medical Center Pkwy
#201
Augusta, ME 04330
Phone (207) 622-1959

149 North St
Waterville, ME 04901
Phone (207) 622-1959

1000 E Primrose St
Ste 520
Springfield, MO 65807
Phone (417) 269-4557

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

603 Beaman St
Ste 200
Clinton, NC 28328
Phone (910) 592-8711

Organizations & group practices 25

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.

View all 25

Hospital & facility affiliations 3

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": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1710210273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40908",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283090908",
            "telephone_number": "910-615-6448",
            "fax_number": "910-615-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 DELANEY AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036003",
            "telephone_number": "910-667-9328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1638 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043424",
            "country_code": "US",
            "telephone_number": "910-615-5132",
            "fax_number": "910-615-5070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 W 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992042307",
            "country_code": "US",
            "telephone_number": "509-474-3131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Rose St",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405366003",
            "country_code": "US",
            "telephone_number": "859-323-5956",
            "fax_number": "859-323-1080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAIRCLOTH",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "4029912",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "159820",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP61525326",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfaircloth134828@direct.nhrmc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2131 S 17th St",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284017407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.