Individual provider Active NPI

Jody L. Heriot, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Lauderdale, FL
National Provider Identifier
1730152919
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP927462 Issued in FL
Practice address
4725 N. Federal Highway
Fort Lauderdale, FL 33308-4603
Phone
(954) 771-8000
Fax
(954) 776-3270
NPI assigned
Feb 9, 2006
Last updated
Aug 28, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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 ARNP927462 FL Primary

Addresses

Primary practice location

4725 N. Federal Highway
Fort Lauderdale, FL 33308-4603

Mailing address

PO Box 551420
Fort Lauderdale, FL 33355-1420
Phone (800) 243-3839

Other identifiers 3

IdentifierTypeStateIssuer
G1492OtherFLBLUE CROSS BLUE SHIELD
G1492OtherBCBS PROVIDER #
306481600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041002000068 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547239808 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Cross Hospital, Inc CurrentSince Jun 1, 2024 Accepting new patients
Holy Cross Hospital Inc Current Accepting new patients
Holy Cross Hospital, Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2024 Accepting new patients
American Anesthesiology Services of Florida, Inc. CurrentSince Dec 1, 2016 Accepting new patients
Princeton Anesthesia Services, PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesco Anesthesia Associates Inc PastSince Sep 16, 1996 Accepting new patients

Locations

21644 State Road 7
Boca Raton, FL 33428
Phone (561) 488-8210

4725 N Federal Hwy
#G
Ft Lauderdale, FL 33308
Phone (954) 492-5748

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1730152919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551420",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333551420",
            "telephone_number": "800-243-3839",
            "fax_number": "855-851-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 N. FEDERAL HIGHWAY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084603",
            "telephone_number": "954-771-8000",
            "fax_number": "954-776-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERIOT",
        "first_name": "JODY",
        "middle_name": "L.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP927462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "G1492",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "G1492",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306481600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.