Juanjeca Quiyatta Barrow
Individual provider Active NPI Certified Registered Nurse Anesthetist · Jackson, TN
NPI 1922746239 · NPPES record last updated Feb 27, 2024
Key facts
- NPI
- 1922746239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 28371 (SC)
- Practice address
- 52 Pemberton CV
Jackson, TN 38305-5514 - Phone
- (731) 234-5663
- NPI assigned
- May 25, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 16
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Beach Anesthesia, LLC
Musc Community Physicians
Tidelands Anesthesia Group LLC
Medstream Anesthesia PLLC
Practice addresses (Care Compare)
109 Blarney Dr
Columbia, SC 29223-6244
Phone (803) 865-8200
4040 Hwy 17
Unit 103
Murrells Inlet, SC 29576-5098
Phone (843) 652-8230
4070 Hwy 17
Murrells Inlet, SC 29576-5033
Phone (843) 652-1000
506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290
606 Black River Rd
Georgetown, SC 29440-3304
Phone (843) 527-7100
Hospital & facility affiliations
- Tidelands Waccamaw Community Hospital
- Tidelands Georgetown Memorial Hospital
- Conway Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240311000711 | SC | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 2567808736 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN230487 | GA | MD | Registered Nurse |
| 28371 | SC | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medstream Anesthesia PLLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Tidelands Anesthesia Group LLC | Current |
Accepting new patients | |
| Beach Anesthesia, LLC | Current |
Accepting new patients |
Locations
109 Blarney Dr
Columbia, SC 29223
Phone (803) 865-8200
606 Black River Rd
Georgetown, SC 29440
Phone (843) 527-7000
2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN230487 | GA | |
| Certified Registered Nurse Anesthetist | 367500000X | 28371 | SC | Yes |
Addresses
Primary practice location
52 Pemberton CV
Jackson, TN 38305-5514
Mailing address
52 Pemberton CV
Jackson, TN 38305-5514
Other providers in Jackson, TN
- Betty A Barnette
- Gregory Stewart Barrett
- Noemi Ballesteros Barroga
- Jessica Stevenson Barron
- Clara Turner Barrow
- Margaret Wilkinson Barth
- Judith Baskin
- Mark Roy Bateman
- Sarah S Bateman
- Stephanie Bates
All providers in Jackson, TN · Certified Registered Nurse Anesthetist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.