Active NPI
Thomas Joseph Jackson, CRNA
- Certified Registered Nurse Anesthetist
- Orlando, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 6160
- Practice address
- 601 E Rollins St
Orlando, FL 32803-1248 - Phone
- (407) 667-0444
- Fax
- (407) 667-4338
- NPI assigned
- Jul 28, 2009
- Last updated
- Jul 28, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 6160 | NC | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | ARNP9185036 | FL |
Addresses
Primary practice location
601 E Rollins St
Orlando, FL 32803-1248
Mailing address
291 Southhall LN Ste 201
Maitland, FL 32751-7290
Phone (407) 667-0444
Other practice location 1
509 N Brightleaf Blvd
Smithfield, NC 27577-4407
Phone (919) 938-6629
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Other | FL | BCBS |
| PENDING | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tjackson836484@direct.UNC.nchie.net | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
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
Practice addresses (Care Compare)
2138 Veterans Pkwy
Clayton, NC 27520-5300
Phone (919) 585-5500
509 N Brightleaf Blvd
Smithfield, NC 27577-4407
Phone (919) 938-6629
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johnston Health Services Corporation | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Johnston Health Services Corporation | Current | Accepting new patients | |
| Regional Anesthesia, PLLC | Current | Accepting new patients | |
| Waterman Anesthesiology Group PA | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186
509 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 934-8171
Organizations & group practices 4
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.
-
- Certified Registered Nurse Anesthetist
- Smithfield, NC
- NPI 1275735425
Nurse Anesthetist, Certified Registered
-
- Specialist
- Durham, NC
- NPI 1952486946
-
dba Johnston Health Outpatient Pharmacy
- Community/Retail Pharmacy
- Smithfield, NC
- NPI 1588069181
-
- Anesthesiology Physician
- Tavares, FL
- NPI 1801130588
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Johnston Health
- General Acute Care Hospital
- Smithfield, NC
- NPI 1619911104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785196800000",
"number": "1740411503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "291 SOUTHHALL LN STE 201",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327517290",
"telephone_number": "407-667-0444",
"fax_number": "407-667-4338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 E ROLLINS ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328031248",
"telephone_number": "407-667-0444",
"fax_number": "407-667-4338"
}
],
"practiceLocations": [
{
"address_1": "509 N Brightleaf Blvd",
"address_purpose": "LOCATION",
"city": "Smithfield",
"state": "NC",
"postal_code": "275774407",
"country_code": "US",
"telephone_number": "919-938-6629",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "THOMAS",
"middle_name": "JOSEPH",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-28",
"last_updated": "2026-07-28",
"certification_date": "2026-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NC",
"license": "6160",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "FL",
"license": "ARNP9185036",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "PENDING",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tjackson836484@direct.UNC.nchie.net",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "509 N Brightleaf Blvd",
"city": "Smithfield",
"state": "NC",
"country_code": "US",
"postal_code": "275774407",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; 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.