Individual provider Active NPI

Anastasia Jackson, CRNA

  • Certified Registered Nurse Anesthetist
  • Joplin, MO
National Provider Identifier
1740835966
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2024043054 Issued in MO
Practice address
100 Mercy Way
Joplin, MO 64804-4524
Phone
(417) 781-2727
NPI assigned
Aug 5, 2019
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 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 2024043054 MO Primary
Registered Nurse 163W00000X 943949 TX
Certified Registered Nurse Anesthetist 367500000X M135050 OK

Addresses

Primary practice location

100 Mercy Way
Joplin, MO 64804-4524

Mailing address

5833 S 79TH East Ave
Tulsa, OK 74145-8656
Phone (310) 795-3752

Other practice location 1

6161 S Yale Ave
Tulsa, OK 74136-1902
Phone (918) 494-0612

Other practice location 2

920 Stanton L Young Blvd
Oklahoma City, OK 73104-5036
Phone (405) 271-4351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX, MO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200205000169 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406282789 Reassigns benefits to 6 organizations
I20221220000713 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406282789 Reassigns benefits to 1 organization
I20241228000091 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406282789 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)

1120 S Utica Ave
HC Med Ctr
Tulsa, OK 74104-4012
Phone (918) 579-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
943949TXMDRegistered Nurse
M135050OKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Oct 31, 2022 Accepting new patients
Northstar Anesthesia of Oklahoma, PLLC CurrentSince Jan 24, 2023 Accepting new patients
Osh Aai PLLC CurrentSince Jan 10, 2020 Accepting new patients
Orthomed Staffing LLC CurrentSince Aug 16, 2023 Accepting new patients
Cherokee Nation CurrentSince Oct 31, 2022 Accepting new patients
Northstar Anesthesia of Missouri, LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2024 Accepting new patients
Ou Health Partners, Inc CurrentSince Feb 3, 2022 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2022 Accepting new patients
Ou Health Partners, Inc CurrentSince Feb 3, 2022 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients

Locations

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

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

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

8100 S Walker Ave
Bldg C
Oklahoma City, OK 73139
Phone (405) 602-6500

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

920 Stanton L Young Blvd
Oklahoma City, OK 73104
Phone (405) 271-5251

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

111 N Bailey St
Pryor, OK 74361
Phone (918) 824-7791

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

19600 E Ross St
Tahlequah, OK 74464
Phone (539) 234-1000

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

6839 S Canton Ave
Tulsa, OK 74136
Phone (918) 494-0612

8801 S 101st East Ave
Tulsa, OK 74133
Phone (800) 965-4565

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 13

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 13

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": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1740835966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5833 S 79TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741458656",
            "telephone_number": "310-795-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MERCY WAY",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044524",
            "telephone_number": "417-781-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6161 S Yale Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741361902",
            "country_code": "US",
            "telephone_number": "918-494-0612",
            "fax_number": "918-392-4693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "920 Stanton L Young Blvd",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731045036",
            "country_code": "US",
            "telephone_number": "405-271-4351",
            "fax_number": "405-271-8695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANASTASIA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2024043054",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "943949",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "M135050",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.