Jerry Ryan Welborn, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R862001 Issued in MS

Practice address

8375 Highway 72 W
Madison, AL 35758-9573

Phone

(205) 265-2012

NPI assigned

Jul 10, 2006

Last updated

Sep 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oxford Anesthesia GroupGroup PAC ID 2668801218, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Oxford Anesthesia Group

  • Certified Registered Nurse Anesthetist
  • Oxford, MS
  • NPI 1093348351

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Willow Anesthesia Services LLC

  • Certified Registered Nurse Anesthetist
  • Oxford, MS
  • NPI 1205169521

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726358400000",
    "number": "1952335572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2045",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393022045",
            "telephone_number": "662-380-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8375 HIGHWAY 72 W",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357589573",
            "telephone_number": "205-265-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELBORN",
        "first_name": "JERRY",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-09-15",
        "certification_date": "2024-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R862001",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-134799",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maura Leigh Weaver, M.S. BCBA
• Elizabeth Larsen Webb, CRNP
• Verne H Webster, M.D.
• Elizabeth McNabb Weinbaum, LPC
• Joanne Lance Weis, ALC
• Alleah N Welch
• Wellness Restoratives, LLC
• Randall J Wendt, MD
• Melissa McDonald Wenzler, RN, IBCLC
• West Counseling and Consulting LLC

• Certified Registered Nurse Anesthetist in Madison, AL
• Providers in Madison, AL by specialty
• Certified Registered Nurse Anesthetist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.