Individual provider Active NPI

Julie Jackson Lewis, CRNA

  • Certified Registered Nurse Anesthetist
  • Savannah, GA
National Provider Identifier
1821363060
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN176488 Issued in GA
Practice address
5353 Reynolds St
Savannah, GA 31405-6015
Phone
(912) 819-6000
NPI assigned
Mar 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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 AP128105 TX
Certified Registered Nurse Anesthetist 367500000X RN176488 GA Primary

Addresses

Primary practice location

5353 Reynolds St
Savannah, GA 31405-6015

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other practice location 1

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-8000

Other practice location 2

929 Gessner Rd Ste 1450
Houston, TX 77024-2317
Phone (713) 442-5200

Other practice location 3

2727 W Holcombe Blvd
Houston, TX 77025-1669
Phone (713) 442-0000

Other practice location 4

11705 Mercy Blvd
Savannah, GA 31419-1711
Phone (912) 819-4100

Other practice location 5

1002 Gemini St Ste 128
Houston, TX 77058-2746
Phone (713) 792-2991

Other practice location 6

101 Saint Josephs Candler Dr
Pooler, GA 31322-9584
Phone (912) 737-2231

Other identifiers 2

IdentifierTypeStateIssuer
369098403MedicaidTX
369098404MedicaidTX

Other names 1

  • Julie Latrace Jackson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120418000530 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163683129 Reassigns benefits to 2 organizations
I20170308002785 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163683129 Reassigns benefits to 2 organizations

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
American Anesthesiology Associates of Georgia LLCGroup PAC ID 7618934779, 230 clinicians
Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

5353 Reynolds St
Savannah, GA 31405-6015
Phone (912) 819-6000

929 Gessner Rd
Suite 1600
Houston, TX 77024-2317
Phone (713) 442-5200

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Dec 5, 2020 Accepting new patients
Anesthesia Consultants of Savannah, PC CurrentSince Apr 1, 2017 Accepting new patients
Baylor College of Medicine CurrentSince Dec 5, 2020 Accepting new patients
Kelsey-Seybold Medical Group, PLLC CurrentSince Feb 13, 2023 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Sep 1, 2022 Accepting new patients

Locations

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

101 Saint Josephs Candler Dr
Pooler, GA 31322
Phone (912) 450-1945

247 S Main St
Reidsville, GA 30453
Phone (478) 787-6255

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140

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

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

929 Gessner Rd
Ste 1600
Houston, TX 77024
Phone (713) 442-5200

929 Gessner Rd
Ste 1450
Houston, TX 77024
Phone (713) 442-5200

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

17200 St Lukes Way
The Woodlands, TX 77384
Phone (936) 266-2008

Organizations & group practices 5

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": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1821363060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 REYNOLDS ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056015",
            "telephone_number": "912-819-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Waters Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-350-8000",
            "fax_number": "912-356-3391",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "929 Gessner Rd Ste 1450",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770242317",
            "country_code": "US",
            "telephone_number": "713-442-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2727 W Holcombe Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770251669",
            "country_code": "US",
            "telephone_number": "713-442-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11705 Mercy Blvd",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314191711",
            "country_code": "US",
            "telephone_number": "912-819-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1002 Gemini St Ste 128",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770582746",
            "country_code": "US",
            "telephone_number": "713-792-2991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Saint Josephs Candler Dr",
            "address_purpose": "LOCATION",
            "city": "Pooler",
            "state": "GA",
            "postal_code": "313229584",
            "country_code": "US",
            "telephone_number": "912-737-2231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JULIE",
        "middle_name": "JACKSON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-21",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP128105",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN176488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "369098403",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "369098404",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "JACKSON",
            "middle_name": "LATRACE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.