Individual provider Active NPI

Jack F Kearns, CRNA

  • Certified Registered Nurse Anesthetist
  • Norwood, MA
National Provider Identifier
1952490146
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
199762 Issued in MA
Practice address
800 Washington St
Anesthesia Department
Norwood, MA 02062-3487
Phone
(781) 278-6524
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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 199762 MA Primary

Addresses

Primary practice location

800 Washington St
Anesthesia Department
Norwood, MA 02062-3487

Mailing address

PO Box 845044
MVP Anesthesia Associates
Boston, MA 02284-5044
Phone (800) 720-1664

Other identifiers 1

IdentifierTypeStateIssuer
430070320OtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050324000898 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7517913353 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
199762MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Anesthesia, P.C. CurrentSince Nov 11, 2015 Accepting new patients
Matrix Anesthesia, PC CurrentSince Oct 31, 2016 Accepting new patients
Jordan Hospital Anesthesia Associates, PC Past Accepting new patients
North Wood Anesthesia Services, P.C. Past Accepting new patients

Locations

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

100 Morse St
Norwood, MA 02062
Phone (781) 255-0362

211 Park St
South Attleboro, MA 02703
Phone (508) 222-5200

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1952490146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845044",
            "address_2": "MVP ANESTHESIA ASSOCIATES",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022845044",
            "telephone_number": "800-720-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "address_2": "ANESTHESIA DEPARTMENT",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020623487",
            "telephone_number": "781-278-6524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARNS",
        "first_name": "JACK",
        "middle_name": "F",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "199762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430070320",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.