Individual provider Active NPI

Jacqueline Richardson, CRNA

  • Certified Registered Nurse Anesthetist
  • Columbus, GA
National Provider Identifier
1811273634
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN218477 Issued in GA
Practice address
616 19TH St
Columbus, GA 31901-1528
Phone
(706) 494-4262
NPI assigned
Oct 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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 RN218477 GA Primary

Addresses

Primary practice location

616 19TH St
Columbus, GA 31901-1528

Mailing address

PO Box 5368
High Point, NC 27262-5368
Phone (706) 494-2194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111110000851 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082888920 Reassigns benefits to 1 organization
I20111114000088 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082888920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keller Anesthesia ServicesGroup PAC ID 4880065929, 18 clinicians

Practice addresses (Care Compare)

1300 S Montgomery Ave
Sheffield, AL 35660-6334
Phone (888) 829-0068

Hospital & facility affiliations

  • Helen Keller Hospital Hospital, Sheffield, AL, CCN 010019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN218477GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Keller Anesthesia Services CurrentSince Oct 26, 2022 Accepting new patients
Amsol Anesthetists of Georgia LLC-Hughston Surgical Center Nurse Anesthetist, Certified Registered CurrentSince Oct 6, 2011 Accepting new patients
Amsol Anesthetists of Georgia, LLC Nurse Anesthetist, Certified Registered Current Accepting new patients

Locations

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

4401 Riverchase Dr
Phenix City, AL 36867
Phone (334) 732-3000

1300 S Montgomery Ave
Sheffield, AL 35660
Phone (256) 386-4005

616 19th St
Columbus, GA 31901
Phone (706) 494-4262

100 Frist Ct
Columbus, GA 31909
Phone (706) 494-2100

6225 State Highway 161
Ste 200
Irving, TX 75038
Phone (214) 687-0496

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 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": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1811273634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5368",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272625368",
            "telephone_number": "706-494-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 19TH ST",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319011528",
            "telephone_number": "706-494-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "JACQUELINE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN218477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; 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.