Individual provider Active NPI

Jessica Henry, CRNA

  • Certified Registered Nurse Anesthetist
  • Glasgow, KY
National Provider Identifier
1861048027
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1131834 Issued in KY
Practice address
1301 N Race St
Glasgow, KY 42141-3483
Phone
(270) 651-4134
Fax
(270) 651-4234
NPI assigned
Aug 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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 1131834 KY Primary

Addresses

Primary practice location

1301 N Race St
Glasgow, KY 42141-3483

Mailing address

639 N Mulberry St
Elizabethtown, KY 42701-1931
Phone (270) 737-4600

Other identifiers 1

IdentifierTypeStateIssuer
7100646720MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200318000440 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002242716 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Anesthesia Services of Kentucky PLLCGroup PAC ID 0244590305, 351 clinicians

Practice addresses (Care Compare)

913 N Dixie Ave
Elizabethtown, KY 42701-2503
Phone (270) 706-1212

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.3 of 100Reported as group
Quality
74.59
Promoting interoperability
100
Improvement activities
40
Cost
68.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1131834KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Anesthesia Services of Kentucky PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 2, 2024 Accepting new patients
T J Samson Community Hospital Nurse Anesthetist, Certified Registered CurrentSince May 10, 2021 Accepting new patients
T J Samson Community Hospital Current Accepting new patients
T J Samson Community Hospital Current Accepting new patients

Locations

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

Organizations & group practices 4

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": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1861048027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 N MULBERRY ST",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011931",
            "telephone_number": "270-737-4600",
            "fax_number": "270-737-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N RACE ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413483",
            "telephone_number": "270-651-4134",
            "fax_number": "270-651-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "JESSICA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1131834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100646720",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glasgow, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.