Individual provider Active NPI

Jacqueline C. Arnett, CRNA

  • Certified Registered Nurse Anesthetist
  • Robbinsdale, MN
National Provider Identifier
1811979503
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1026481 Issued in MN
Practice address
3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone
(763) 581-3980
Fax
(763) 581-3591
NPI assigned
Nov 17, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R071891 GA
Certified Registered Nurse Anesthetist 367500000X 1026481 MN Primary

Addresses

Primary practice location

3300 Oakdale Ave N
Robbinsdale, MN 55422

Mailing address

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-3980

Other practice location 1

405 Arrowhead Blvd
Jonesboro, GA 30236-1254
Phone (770) 472-7731

Other identifiers 1

IdentifierTypeStateIssuer
00559688AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MN, VI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20110322000399 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860542792 Reassigns benefits to 9 organizations
I20181214001149 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860542792 Reassigns benefits to 1 organization
I20240628002571 VI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860542792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gi Anesthesia of Georgia LLCGroup PAC ID 0446516769, 117 clinicians
At Your Service Anesthesia and Therapeutics LLCGroup PAC ID 0840663654, 6 clinicians

Practice addresses (Care Compare)

1269 Wellbrook Cir NE
Conyers, GA 30012-3873
Phone (770) 922-0505

1785 E Park Place Blvd
Suite 212
Stone Mountain, GA 30087-3458
Phone (770) 395-6076

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1886MNMDMarriage & Family Therapist
R071891GAMDCertified Registered Nurse Anesthetist
1026481MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Derrick D. Jones P C CurrentSince May 14, 2024 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2020 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Apr 17, 2023 Accepting new patients
Rockdale Anesthesia Services, P.C. CurrentSince Feb 1, 2011 Accepting new patients
At Your Service Anesthesia and Therapeutics, LLC CurrentSince Jan 1, 2023 Accepting new patients
Piedmont Anesthesia LLC CurrentSince Nov 1, 2025 Accepting new patients
Anesthesia Consultants of Savannah, PC CurrentSince Apr 1, 2017 Accepting new patients
Gi Anesthesia of Georgia LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2021 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince May 19, 2012 Accepting new patients
Capitol Anesthesiology, PC CurrentSince Jul 1, 2024 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince May 19, 2012 Accepting new patients
Coastal Ambulatory Anesthesia LLC CurrentSince May 1, 2022 Accepting new patients

Locations

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

340 N Milledge Ave
Ste A
Athens, GA 30601
Phone (706) 548-0008

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1269 Wellbrook Cir NE
Conyers, GA 30012
Phone (770) 922-0505

1380 Milstead Ave NE
Ste G
Conyers, GA 30012
Phone (770) 388-7745

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1612 Milstead Rd NE
#B
Conyers, GA 30012
Phone (770) 388-7745

7229 Wheat St NE
Covington, GA 30014
Phone (678) 625-5132

2675 N Decatur Rd
Ste 506
Decatur, GA 30033
Phone (404) 299-1679

1336 Highway 54 W
Bldg 400
Fayetteville, GA 30214
Phone (770) 461-1238

1955 Textile Way
Gainesville, GA 30501
Phone (678) 987-1499

4865 Bill Gardner Pkwy
Locust Grove, GA 30248
Phone (770) 692-0100

156 Foster Dr
Ste A
McDonough, GA 30253
Phone (404) 932-0295

156 Foster Dr
Spc C
McDonough, GA 30253

1000 Corporate Center Dr
Ste 180
Morrow, GA 30260
Phone (770) 968-8888

6555 Professional Pl
Ste B
Riverdale, GA 30274
Phone (770) 692-0100

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

1139 Lexington Ave
Savannah, GA 31404
Phone (912) 303-4200

180 N Park Trl
#200
Stockbridge, GA 30281
Phone (678) 565-1806

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

1785 E Park Place Blvd
Ste 212
Stone Mtn, GA 30087
Phone (470) 395-6076

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

9003 Havensight Shopp Ctr
Ste 307
St Thomas, VI 00802
Phone (877) 464-9046

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1811979503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222926",
            "telephone_number": "763-581-3980",
            "fax_number": "763-581-3591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "55422",
            "telephone_number": "763-581-3980",
            "fax_number": "763-581-3591"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 Arrowhead Blvd",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "GA",
            "postal_code": "302361254",
            "country_code": "US",
            "telephone_number": "770-472-7731",
            "fax_number": "770-478-2908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARNETT",
        "first_name": "JACQUELINE",
        "middle_name": "C.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "R071891",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "1026481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00559688A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Robbinsdale, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.