Individual provider Active NPI

Jason M Larsen, CRNA, DNP

  • Certified Registered Nurse Anesthetist
  • Lexington, KY
National Provider Identifier
1922439264
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4018931 Issued in KY
Practice address
800 Rose St
Lexington, KY 40536-8237
Phone
(859) 323-5956
Fax
(859) 323-1080
NPI assigned
Dec 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APN19921 TN
Certified Registered Nurse Anesthetist 367500000X 4018931 KY Primary

Addresses

Primary practice location

800 Rose St
Lexington, KY 40536-8237

Mailing address

1009 Novus Dr Ste 2
Johnson City, TN 37604-8237
Phone (423) 283-0776

Other practice location 1

1009 Novus Dr Ste 2
Johnson City, TN 37604-8237
Phone (423) 283-0776

Other identifiers 1

IdentifierTypeStateIssuer
Q016239MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NC, SC, KY4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20150826001888 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315178670 Reassigns benefits to 1 organization
I20231102003141 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315178670 Reassigns benefits to 1 organization
I20240409000577 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315178670 Reassigns benefits to 1 organization
I20240821003064 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315178670 Reassigns benefits to 1 organization

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
Paragon Anesthesia PCGroup PAC ID 8921044744, 214 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 390-0451

Hospital & facility affiliations

  • Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as group
Quality
78.19
Promoting interoperability
100
Improvement activities
40
Cost
70.17

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28448SCMDInternal Medicine Physician
4018931KYMDCertified Registered Nurse Anesthetist
APN19921TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Jul 18, 2024 Accepting new patients
East Tennessee Ambulatory Surgery Center LLC CurrentSince Jul 22, 2022 Accepting new patients
Musc Community Physicians CurrentSince Apr 1, 2024 Accepting new patients
Musc Community Physicians Current Accepting new patients
CHS Anesthesia Services Group Inc CurrentSince Aug 15, 2023 Accepting new patients
Paragon Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Jul 22, 2022 Accepting new patients
Musc Community Physicians CurrentSince Apr 1, 2024 Accepting new patients
Singing River Health System Past Accepting new patients

Locations

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

10415 Wallace Alley St
Kingsport, TN 37663
Phone (423) 390-0451

Organizations & group practices 8

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": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1922439264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 NOVUS DR STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048237",
            "telephone_number": "423-283-0776",
            "fax_number": "423-283-0549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405368237",
            "telephone_number": "859-323-5956",
            "fax_number": "859-323-1080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1009 Novus Dr Ste 2",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376048237",
            "country_code": "US",
            "telephone_number": "423-283-0776",
            "fax_number": "423-283-0549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "JASON",
        "middle_name": "M",
        "credential": "CRNA, DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-12",
        "last_updated": "2024-07-09",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN19921",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "4018931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q016239",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.