Individual provider Active NPI

Jaden Peterson, CRNA

  • Certified Registered Nurse Anesthetist
  • Phoenix, AZ
National Provider Identifier
1972332658
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
328674 Issued in AZ
Practice address
6501 N 19TH Ave
Phoenix, AZ 85015-1646
Phone
(602) 795-6020
NPI assigned
Jul 30, 2024
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN316201 GA
Certified Registered Nurse Anesthetist 367500000X 328674 AZ Primary

Addresses

Primary practice location

6501 N 19TH Ave
Phoenix, AZ 85015-1646

Mailing address

7301 N 16TH St Ste 102
Phoenix, AZ 85020-5266
Phone (480) 420-4027

Other practice location 1

1120 15th St
Augusta, GA 30912-0004
Phone (435) 619-5548

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250925004986 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567967979 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Partners and Management LLCGroup PAC ID 9931429198, 151 clinicians
Guide Anesthesia Az LLCGroup PAC ID 1355846106, 102 clinicians

Practice addresses (Care Compare)

6501 N 19TH Ave
Phoenix, AZ 85015-0907
Phone (480) 420-4027

6501 N 19TH Ave
Phoenix, AZ 85015-1646
Phone (602) 795-6020

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN316201GAMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Partners & Management LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 10, 2025 Accepting new patients
Guide Anesthesia Az LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 3, 2025 Accepting new patients

Locations

1020 N San Francisco St
Ste 100
Flagstaff, AZ 86001
Phone (928) 774-2300

3591 S Mercy Rd
Ste 101
Gilbert, AZ 85297

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

6501 N 19th Ave
Phoenix, AZ 85015
Phone (602) 314-4280

7301 N 16th St
Ste 102
Phoenix, AZ 85020
Phone (602) 772-8600

3900 E Camelback Rd
Ste 190
Phoenix, AZ 85018
Phone (888) 724-6236

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

3110 Clearwater Dr
Prescott, AZ 86305
Phone (623) 241-6185

8952 E Desert Cove Ave
Ste 113
Scottsdale, AZ 85260
Phone (480) 314-7772

10494 W Thunderbird Blvd
Ste 102
Sun City, AZ 85351
Phone (623) 975-8311

10494 W Thunderbird Blvd
Ste 108
Sun City, AZ 85351
Phone (623) 474-3672

1704 W Anklam Rd
Ste 108
Tucson, AZ 85745
Phone (623) 241-6185

1030 W 24th St
Ste H
Yuma, AZ 85364
Phone (520) 726-5151

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1972332658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 N 16TH ST STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205266",
            "telephone_number": "480-420-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151646",
            "telephone_number": "602-795-6020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 15th St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309120004",
            "country_code": "US",
            "telephone_number": "435-619-5548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JADEN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-30",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "GA",
            "license": "RN316201",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "328674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.