Individual provider Active NPI

Jennifer A. Davis, CRNA

  • Certified Registered Nurse Anesthetist
  • Montgomery, AL
National Provider Identifier
1760449375
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-056656 Issued in AL
Practice address
470 Taylor Rd
Montgomery, AL 36117-3563
Phone
(334) 226-4048
Fax
(334) 323-5675
NPI assigned
Apr 27, 2006
Last updated
Sep 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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 1-056656 AL Primary

Addresses

Primary practice location

470 Taylor Rd
Montgomery, AL 36117-3563

Mailing address

2151 Old Rocky Ridge Road
Suite 106
Birmingham, AL 35216-7251
Phone (205) 989-1080

Other practice location 1

1725 Pine St
Montgomery, AL 36106-1109
Phone (334) 293-8000

Other identifiers 4

IdentifierTypeStateIssuer
000073769MedicaidAL
430054184OtherALMEDICARE RR
009937816MedicaidAL
510-90432OtherALBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060914000588 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648274126 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Anesthesia of Montgomery PCGroup PAC ID 5799684148, 117 clinicians

Practice addresses (Care Compare)

470 Taylor Rd
Suite 100
Montgomery, AL 36117-3532
Phone (334) 290-4530

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 2, 2020 Accepting new patients
Montgomery Anesthesia Associates, PC Nurse Anesthetist, Certified Registered PastSince Apr 20, 2025 Accepting new patients

Locations

2752 Zelda Rd
Montgomery, AL 36106
Phone (334) 270-9677

25B Hanover Rd
Ste 250
Florham Park, NJ 07932

Organizations & group practices 3

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1760449375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 OLD ROCKY RIDGE ROAD",
            "address_2": "SUITE 106",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352167251",
            "telephone_number": "205-989-1080",
            "fax_number": "205-989-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 TAYLOR RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173563",
            "telephone_number": "334-226-4048",
            "fax_number": "334-323-5675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1725 Pine St",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361061109",
            "country_code": "US",
            "telephone_number": "334-293-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JENNIFER",
        "middle_name": "A.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-056656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000073769",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "430054184",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009937816",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "510-90432",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.