Individual provider Active NPI

Theresa J Jones, CRNA

  • Certified Registered Nurse Anesthetist
  • Roswell, NM
National Provider Identifier
1861651218
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R41752 Issued in NM
Practice address
405 W Country Club Rd
Roswell, NM 88201-5209
Phone
(575) 622-8170
NPI assigned
Jun 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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 R41752 NM Primary

Addresses

Primary practice location

405 W Country Club Rd
Roswell, NM 88201-5209

Mailing address

405 W Country Club Rd
C/O Mso Administration
Roswell, NM 88201-5209
Phone (575) 622-8170

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080813000630 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769557586 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R41752NMMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of New Mexico P C CurrentSince Nov 1, 2013 Accepting new patients
Main Street Anesthesia of New Mexico, LLC CurrentSince May 1, 2024 Accepting new patients
Texas Anesthesia Specialists PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Specialists of Albuquerque Past Accepting new patients

Locations

1720 Louisiana Blvd NE
Ste 401
Albuquerque, NM 87110
Phone (505) 260-4300

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

2100 N Mlk Blvd
Clovis, NM 88101
Phone (505) 769-2141

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7000

405 W Country Club Rd
Roswell, NM 88201
Phone (505) 622-8170

117 E 19th St
Roswell, NM 88201
Phone (505) 727-2000

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.

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1861651218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W COUNTRY CLUB RD",
            "address_2": "C/O MSO ADMINISTRATION",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015209",
            "telephone_number": "575-622-8170",
            "fax_number": "575-624-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W COUNTRY CLUB RD",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015209",
            "telephone_number": "575-622-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "THERESA",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "R41752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.