Individual provider Active NPI

Jason Shane Bruce, CRNA

  • Certified Registered Nurse Anesthetist
  • Okmulgee, OK
National Provider Identifier
1740218866
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R 0085091 Issued in OK
Practice address
1401 Morris Dr
Okmulgee, OK 74447-6429
Phone
(918) 756-3177
NPI assigned
Jun 29, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 R 0085091 OK Primary
Certified Registered Nurse Anesthetist 367500000X 2004003392 MO

Addresses

Primary practice location

1401 Morris Dr
Okmulgee, OK 74447-6429

Mailing address

18162 Old Morris Hwy
Okmulgee, OK 74447
Phone (918) 733-9824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060928000267 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264402866 Reassigns benefits to 2 organizations
I20210121000135 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264402866 Reassigns benefits to 1 organization

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
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Practice addresses (Care Compare)

1027 E Cherry St
HC Hosp Cushing
Cushing, OK 74023-4101
Phone (918) 225-2915

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
48.28 of 100Reported as group
Quality
21.69
Improvement activities
40
Cost
71.16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R 0085091OKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Oklahoma, PLLC CurrentSince Sep 1, 2023 Accepting new patients
Labette County Medical Center CurrentSince Jan 1, 2021 Accepting new patients
Labette County Medical Center Current Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 20, 2024 Accepting new patients
Labette County Medical Center CurrentSince Jan 1, 2021 Accepting new patients
Freeman Neosho Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Omh Home Health Past Accepting new patients

Locations

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

1902 S US Highway 59
Parsons, KS 67357
Phone (620) 421-4880

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

1027 E Cherry St
Cushing, OK 74023
Phone (918) 225-2915

5602 SW Lee Blvd
Lawton, OK 73505
Phone (580) 531-4700

10512 N 110th East Ave
Owasso, OK 74055
Phone (918) 272-1172

12451 E 100th St N
Owasso, OK 74055
Phone (918) 274-5000

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

Organizations & group practices 7

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.

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1740218866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18162 OLD MORRIS HWY",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "74447",
            "telephone_number": "918-733-9824",
            "fax_number": "918-733-9825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MORRIS DR",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744476429",
            "telephone_number": "918-756-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "JASON",
        "middle_name": "SHANE",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "R 0085091",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2004003392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okmulgee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.