Individual provider Active NPI

Jeremy Michael Ussery, CRNA

  • Certified Registered Nurse Anesthetist
  • North Little Rock, AR
National Provider Identifier
1952671828
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
#CTP-00182 Issued in AR
Practice address
3333 Springhill Dr
North Little Rock, AR 72117-2922
Phone
(501) 202-3000
NPI assigned
Jan 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 RNLICENSE#R79237 AR
Certified Registered Nurse Anesthetist 367500000X #CTP-00182 AR Primary

Addresses

Primary practice location

3333 Springhill Dr
North Little Rock, AR 72117-2922

Mailing address

3715 Monarch CV
Conway, AR 72034-3374
Phone (501) 472-9034

Other practice location 1

3810 Central Avenue
Suite H
Hot Springs, AR 71913
Phone (501) 525-5840

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120214000139 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961669338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conway Anesthesiology Consultants, PAGroup PAC ID 6901796267, 22 clinicians

Practice addresses (Care Compare)

2302 College Ave
Conway, AR 72034-6297
Phone (501) 327-6665

Hospital & facility affiliations

  • Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029

Merit-based Incentive Payment System (MIPS)

Final score
84.14 of 100Reported as group
Quality
83.98
Improvement activities
40
Cost
76.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RNLICENSE#R79237ARMDRegistered Nurse
#CTP-00182ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Anesthesiology Consultants, P.a. CurrentSince Oct 16, 2017 Accepting new patients
Midstate Medical Services PA PastSince Aug 7, 2012 Accepting new patients

Locations

2302 College Ave
Conway, AR 72034
Phone (501) 329-3831

Organizations & group practices 2

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 6

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": "1326067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1952671828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 MONARCH CV",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343374",
            "telephone_number": "501-472-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SPRINGHILL DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172922",
            "telephone_number": "501-202-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3810 Central Avenue",
            "address_2": "Suite H",
            "address_purpose": "LOCATION",
            "city": "Hot Springs",
            "state": "AR",
            "postal_code": "71913",
            "country_code": "US",
            "telephone_number": "501-525-5840",
            "fax_number": "501-525-1762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "USSERY",
        "first_name": "JEREMY",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "RNLICENSE#R79237",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "#CTP-00182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.