NPIMap

Individual provider Active NPI

Jessie Louise Dejong, APRN, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1861201865
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1186482 Issued in TX
Practice address
5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone
(214) 590-8000
NPI assigned
Jan 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 952630 TX
Certified Registered Nurse Anesthetist 367500000X 1186482 TX Primary

Addresses

Primary practice location

5200 Harry Hines Blvd
Dallas, TX 75235-7709

Mailing address

433 Circleview Dr S
Hurst, TX 76054-3524
Phone (903) 504-4154

Other names 1

  • Jessie Louise Elliott Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250807004572 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204334378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas County Hospital DistrictGroup PAC ID 8325934813, 597 clinicians

Practice addresses (Care Compare)

5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone (214) 590-8006

Hospital & facility affiliations

  • Parkland Health & Hospital System Hospital, Dallas, TX, CCN 450015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
952630TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District Nurse Anesthetist, Certified Registered CurrentSince Jul 25, 2025 Accepting new patients
Dallas County Hospital District Current Accepting new patients
Dallas County Hospital District CurrentSince Jul 25, 2025 Accepting new patients

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 45

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1735862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1861201865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 CIRCLEVIEW DR S",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760543524",
            "telephone_number": "903-504-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357709",
            "telephone_number": "214-590-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJONG",
        "first_name": "JESSIE",
        "middle_name": "LOUISE",
        "credential": "APRN, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-03",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "952630",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1186482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSIE",
            "last_name": "ELLIOTT",
            "middle_name": "LOUISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.