Individual provider Active NPI

Lauren Jackel

  • Certified Registered Nurse Anesthetist
  • Madison, TN
National Provider Identifier
1922776913
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28286326A Issued in IN
Practice address
315 Hospital Dr
Madison, TN 37115-5030
Phone
(615) 732-7670
NPI assigned
Sep 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1158598 KY
Certified Registered Nurse Anesthetist 367500000X 28286326A IN Primary

Addresses

Primary practice location

315 Hospital Dr
Madison, TN 37115-5030

Mailing address

101 Spade Leaf Blvd Apt 1213
Hendersonville, TN 37075-4476
Phone (502) 468-8996

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240305003740 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981049566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Indiana LLCGroup PAC ID 1153576905, 130 clinicians

Practice addresses (Care Compare)

1850 State St
New Albany, IN 47150-4990
Phone (812) 944-7701

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1158598KYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Indiana LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 12, 2024 Accepting new patients

Locations

13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

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.

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": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1922776913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SPADE LEAF BLVD APT 1213",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370754476",
            "telephone_number": "502-468-8996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 HOSPITAL DR",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371155030",
            "telephone_number": "615-732-7670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKEL",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1158598",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28286326A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.