Jason Tibbett, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP07594 Issued in LA

Practice address

200 Tyler St
West Memphis, AR 72301

Phone

(870) 735-1500

Fax

(870) 733-3861

NPI assigned

Mar 25, 2011

Last updated

Dec 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novus Louisiana Medical Professional CorporationGroup PAC ID 5395194880, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Specialists Hospital Shreveport Hospital, Shreveport, LA, CCN 190278
• Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Novus Louisiana Medical Professional Corporation

  • Anesthesiology Physician
  • Shreveport, LA
  • NPI 1336926872

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Medical Center Anesthesiologists

  • Anesthesiology Physician
  • Shreveport, LA
  • NPI 1669469748
  Medicare reassignment NPD
• Mid-Louisiana Anesthesia Consultants, Apmc

  • Anesthesiology Physician
  • Alexandria, LA
  • NPI 1205888914
  Medicare reassignment NPD
• Natchitoches Anesthesia Associates LLC

  • Certified Registered Nurse Anesthetist
  • Natchitoches, LA
  • NPI 1992827182

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Crittenden Hospital Association

  dba Arkansas Delta Anesthesia

  • Anesthesiology Physician
  • West Memphis, AR
  • NPI 1821113879
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Health Northern Louisiana

  dba Christus Shreveport-Bossier Health System

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1417950106
  Care Compare affiliation
• Specialists Hospital Shreveport, LLC

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1912118134
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1790084028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5887",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713075887",
            "telephone_number": "870-735-1500",
            "fax_number": "870-733-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TYLER ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "72301",
            "telephone_number": "870-735-1500",
            "fax_number": "870-733-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBETT",
        "first_name": "JASON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-25",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP07594",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "169954",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN LICENSE",
            "identifier": "169954",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Thompson, DPT
• Tanisha Kisha Thompson, LMSW
• Erica Lynette Thornton, LPN
• Sharon E Thorpe, FNP
• Schrondria Lacy Thurman
• Raena R Tinnon
• Tlo Care LLC
• Geral Towne
• Lynda Townsend
• Traylor Chiropractic Clinics

• Certified Registered Nurse Anesthetist in West Memphis, AR
• Providers in West Memphis, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; 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.