Jon Boyd Poulson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN.CRNA.06711 Issued in OH

Practice address

401 Matthew St
Marietta, OH 45750-1635

Phone

(740) 568-5427

NPI assigned

Jun 21, 2006

Last updated

Oct 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH, WV2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marietta Memorial Hospital Hospital, Marietta, OH, CCN 360147

Medicare enrollment (NPD)

Enrolled

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.

• River Front Anesthesia Inc

  • Anesthesiology Physician
  • Belpre, OH
  • NPI 1578836565

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• United Anesthesia, Inc.

  • Anesthesiology Physician
  • Parkersburg, WV
  • NPI 1477512408

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Maran, Inc.

  • Anesthesiology Physician
  • Marietta, OH
  • NPI 1497873483

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Marietta Anesthesia Care, Inc.

  • Anesthesiology Physician
  • Marietta, OH
  • NPI 1841230703
  NPD (past)

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

• Marietta Memorial Hospital

  • General Acute Care Hospital
  • Marietta, OH
  • NPI 1215936927
  Care Compare affiliation

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1801832506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RIVERSIDE LN",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457501448",
            "telephone_number": "740-336-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MATTHEW ST",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457501635",
            "telephone_number": "740-568-5427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1106 Colegate Dr",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "OH",
            "postal_code": "457501323",
            "country_code": "US",
            "telephone_number": "740-568-2000",
            "fax_number": "740-568-2094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POULSON",
        "first_name": "JON",
        "middle_name": "BOYD",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "56808",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN233430",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.06711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anesthesia.providers@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "401 Matthew St",
            "city": "Marietta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457501635",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anesthesia.providers@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "1106 Colegate Dr",
            "city": "Marietta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457501323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Natalie Nicole Ponchak
• Kimberly Poole
• Teresa R Porter, LPPC
• Kylie Postle
• Tamara Rena Postlethwait, FNP-BC
• Paul Prachun, MD
• Amal Prazad
• Susan E Presseau, MD
• Haley Pressley
• Private Healthcare Facilities

• Certified Registered Nurse Anesthetist in Marietta, OH
• Providers in Marietta, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.