Individual provider Active NPI

Jonathan Lincoln, CRNA

  • Certified Registered Nurse Anesthetist
  • Deland, FL
National Provider Identifier
1912387622
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9281039 Issued in FL
Practice address
701 W Plymouth Ave
Deland, FL 32720-3236
Phone
(407) 667-0444
Fax
(407) 667-4338
NPI assigned
Jun 8, 2015
Last updated
Jun 8, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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 ARNP9281039 FL Primary

Addresses

Primary practice location

701 W Plymouth Ave
Deland, FL 32720-3236

Mailing address

291 Southhall LN
Maitland, FL 32751-7274
Phone (407) 667-0444

Other identifiers 2

IdentifierTypeStateIssuer
PENDINGMedicaidFL
PENDINGOtherFLBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230628001469 WY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709192560 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Campbell County Hospital DistrictGroup PAC ID 2860392529, 128 clinicians

Practice addresses (Care Compare)

501 S Burma Ave
Gillette, WY 82716-3426
Phone (307) 688-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of Carbon County CurrentSince Jul 8, 2024 Accepting new patients
Campbell County Hospital District CurrentSince Jul 3, 2023 Accepting new patients
Memorial Hospital of Carbon County Current Accepting new patients
Pinnacle Anesthesia Services LLC CurrentSince May 20, 2023 Accepting new patients
Campbell County Hospital District Current Accepting new patients
Memorial Hospital of Carbon County CurrentSince Jul 8, 2024 Accepting new patients
Campbell County Hospital District Current Accepting new patients
Campbell County Hospital District CurrentSince Jul 3, 2023 Accepting new patients
Pinnacle Anesthesia Services Aspen Mountain LLC Past Accepting new patients

Locations

501 S Burma Ave
Gillette, WY 82716
Phone (307) 682-8811

2221 Elm St
Rawlins, WY 82301
Phone (307) 324-2221

300 3rd St
Rawlins, WY 82301
Phone (307) 324-3403

2761 Commercial Way
Rock Springs, WY 82901
Phone (307) 382-3064

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1912387622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 SOUTHHALL LN",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517274",
            "telephone_number": "407-667-0444",
            "fax_number": "407-667-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203236",
            "telephone_number": "407-667-0444",
            "fax_number": "407-667-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINCOLN",
        "first_name": "JONATHAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-08",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9281039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.