Jacob Troy Russell, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

CRNA1226 Issued in AZ

Practice address

807 S Ponderosa St
Payson, AZ 85541-5542

Phone

(928) 472-1273

NPI assigned

Jul 31, 2016

Last updated

Jul 31, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sleepy Plains Anesthesia LLCGroup PAC ID 4284960352, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Plains Regional Medical Center Hospital, Clovis, NM, CCN 320022
• Roosevelt General Hospital Hospital, Portales, NM, CCN 320084

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.

• Sleepy Plains Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Clovis, NM
  • NPI 1265090344

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Anesthesia Associates of New Mexico P C

  • Specialist
  • Albuquerque, NM
  • NPI 1912900754
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Presbyterian Healthcare Services

  dba Plains Regional Medical Center

  • Rural Acute Care Hospital
  • Clovis, NM
  • NPI 1629053509
  Care Compare affiliation
• Roosevelt County Special Hospital District

  dba Roosevelt General Hospital

  • General Acute Care Hospital
  • Portales, NM
  • NPI 1073517058
  Care Compare affiliation

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

{
    "created_epoch": "1469923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469923200000",
    "number": "1972056588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 W SIERRA CIR",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855416602",
            "telephone_number": "480-209-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 S PONDEROSA ST",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415542",
            "telephone_number": "928-472-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JACOB",
        "middle_name": "TROY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-31",
        "last_updated": "2016-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "CRNA1226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodney D Anderson PLLC (Chiropractic Care)
• Alex E Romberger, DDS
• Kirt Rosenlof, CRNA
• Rta Hospice, LLC
• Harold Robert Rush, DDS
• Megan Fragale Saalfrank, PHARMD
• Safeway Inc (Safeway Pharmacy #1536)
• Cynthia L Sambrano, MT-BC, NMT
• Robert Jon Sanders, DC
• Paul Schoeneberger, PA

• Certified Registered Nurse Anesthetist in Payson, AZ
• Providers in Payson, AZ by specialty
• Certified Registered Nurse Anesthetist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2016; 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.