Active NPI
Jacqueline Lee Wharton, CRNA
- Certified Registered Nurse Anesthetist
- Mechanicsville, VA
National Provider Identifier
1912055302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 0024058884
- Practice address
- 8260 Atlee Road
Mechanicsville, VA 23116-1844 - Phone
- (804) 288-4921
- Fax
- (804) 282-9921
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 0024058884 | VA | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | 114808 | NC | |
| Certified Registered Nurse Anesthetist | 367500000X | 029576 | NC |
Addresses
Primary practice location
8260 Atlee Road
Mechanicsville, VA 23116-1844
Mailing address
804 Scott Nixon Memorial Drive
Augusta, GA 30907-2464
Phone (800) 394-4445
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 029576 | NC | MD | Certified Registered Nurse Anesthetist |
| 114808 | NC | MD | Certified Registered Nurse Anesthetist |
| 0024058884 | VA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hanover Anesthesia Group,Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Mechanicsville, VA
- NPI 1558387738
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352764800000",
"number": "1912055302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 SCOTT NIXON MEMORIAL DRIVE",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309072464",
"telephone_number": "800-394-4445",
"fax_number": "706-650-1034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8260 ATLEE ROAD",
"city": "MECHANICSVILLE",
"state": "VA",
"postal_code": "231161844",
"telephone_number": "804-288-4921",
"fax_number": "804-282-9921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHARTON",
"first_name": "JACQUELINE",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2012-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "VA",
"license": "0024058884",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NC",
"license": "114808",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NC",
"license": "029576",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mechanicsville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.