Individual provider Active NPI

Jaclyn Woods, CRNA

  • Certified Registered Nurse Anesthetist
  • Flint, MI
National Provider Identifier
1760028401
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
470431903 Issued in MI
Practice address
303 E Kearsley St
Flint, MI 48502-1907
Phone
(810) 923-9949
NPI assigned
Nov 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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 470431903 MI Primary

Addresses

Primary practice location

303 E Kearsley St
Flint, MI 48502-1907

Mailing address

303 E Kearsley St
Flint, MI 48502-1907

Other names 1

  • Jaclyn Beverley Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210831000695 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022414051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Michigan Medical School, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hurley Medical CenterGroup PAC ID 2961308481, 336 clinicians

Practice addresses (Care Compare)

1 Hurley PLZ
Flint, MI 48503-5902
Phone (810) 262-9353

Hospital & facility affiliations

  • Hurley Medical Center Hospital, Flint, MI, CCN 230132

Merit-based Incentive Payment System (MIPS)

Final score
92.4 of 100Reported as group
Quality
66.97
Promoting interoperability
100
Improvement activities
40
Cost
75.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
470431903MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hurley Medical Center CurrentSince Sep 8, 2021 Accepting new patients
Hurley Medical Center Nurse Anesthetist, Certified Registered CurrentSince Sep 8, 2021 Accepting new patients

Locations

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1760028401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E KEARSLEY ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485021907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E KEARSLEY ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485021907",
            "telephone_number": "810-923-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "JACLYN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "470431903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "BEVERLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.