JT Anesthesia Prof LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

JT ANESTHESIA PROF LLC

Practice address

32521 139TH Street
Bowdle, SD 57428

Phone

(302) 420-9101

NPI assigned

Oct 28, 2019

Last updated

Oct 28, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica Ann Medori Heinrich, CRNA

Title

Crna

Phone

(302) 420-9101

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572220800000",
    "number": "1851934335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32521 139TH STREET",
            "city": "BOWDLE",
            "state": "SD",
            "postal_code": "57428",
            "telephone_number": "302-420-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32521 139TH STREET",
            "city": "BOWDLE",
            "state": "SD",
            "postal_code": "57428",
            "telephone_number": "302-420-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JT ANESTHESIA PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-10-28",
        "status": "A",
        "authorized_official_last_name": "HEINRICH",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "ANN MEDORI",
        "authorized_official_title_or_position": "CRNA",
        "authorized_official_telephone_number": "302-420-9101",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bowdle Hospital
• Bowdle Hospital (Bowdle Hospital Assisted Living)
• Bowdle Hospital (Bowdle Rural Health Clinic)
• Bowdle School 22-1
• Lori J Eisenbeisz, D.C.
• Lacey Kessler, MD
• Amanda Kramer, P.A.
• John C Ottenbacher, MD
• Travis H Preszler, PA-C
• Turner Drug Inc

• Certified Registered Nurse Anesthetist in Bowdle, SD
• Providers in Bowdle, SD by specialty
• Certified Registered Nurse Anesthetist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.