Individual provider Active NPI

Amelia R Jordan, CRNA

  • Certified Registered Nurse Anesthetist
  • Huntsville, AL
National Provider Identifier
1801190681
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-111795 Issued in AL
Practice address
721 Madison St SE
Huntsville, AL 35801-4408
Phone
(256) 880-6711
Fax
(256) 880-6712
NPI assigned
Jan 7, 2011
Last updated
Mar 7, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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 1-111795 AL Primary

Addresses

Primary practice location

721 Madison St SE
Huntsville, AL 35801-4408

Mailing address

PO Box 288
Huntsville, AL 35804-0288
Phone (256) 880-6711

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120329000460 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446428809 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Tennessee, HSC, College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Services of Decatur, P.C.Group PAC ID 4183618226, 14 clinicians
Huntsville Hospital AnesthesiaGroup PAC ID 7315990751, 157 clinicians

Practice addresses (Care Compare)

1122 14TH Ave SE
Decatur, AL 35601-3361
Phone (256) 764-9697

245 Governors Dr SE
Huntsville, AL 35801-3784
Phone (256) 265-8120

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-111795ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Huntsville Anesthesiology Consultants PC Nurse Anesthetist, Certified Registered CurrentSince Feb 12, 2012 Accepting new patients
Anesthesia Services of Decatur PC CurrentSince Mar 16, 2024 Accepting new patients
Huntsville Hospital Anesthesia Nurse Anesthetist, Certified Registered CurrentSince Mar 16, 2015 Accepting new patients
Medical Anesthesia Group, PA PastSince Feb 24, 1997 Accepting new patients

Locations

1122 14th Ave SE
Decatur, AL 35601
Phone (256) 560-2890

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

201 Governors Dr SW
Huntsville, AL 35801
Phone (256) 265-6851

245 Governors Dr SE
Huntsville, AL 35801
Phone (256) 265-7673

721 Madison St SE
Huntsville, AL 35801
Phone (256) 533-4888

8375 Highway 72 W
Madison, AL 35758
Phone (256) 265-2012

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.

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": "1294358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1801190681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 288",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358040288",
            "telephone_number": "256-880-6711",
            "fax_number": "256-880-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 MADISON ST SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014408",
            "telephone_number": "256-880-6711",
            "fax_number": "256-880-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "AMELIA",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-07",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-111795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; 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.