Jacob C Carroll, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

22130 Issued in TN

Practice address

935 Wayne Rd
Savannah, TN 38372

Phone

(731) 926-8000

NPI assigned

Jan 5, 2017

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 TN

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

Medical Center Anesthesia, IncGroup PAC ID 2769629187, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002

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 and National Provider Directory roles.

• Medical Center Anesthesia Inc.

  • Anesthesiology Physician
  • Jackson, TN
  • NPI 1447591730

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Lifelinc Anesthesia II, PLLC

  • Anesthesiology Physician
  • Springfield, TN
  • NPI 1821397233

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Lifelinc Anesthesia, PLLC

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1801021464

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Jackson Anesthesiology Group, PLLC

  • Anesthesiology Physician
  • Jackson, TN
  • NPI 1770187734
  NPD (past)

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

• Jackson Madison County General Hospital

  • General Acute Care Hospital
  • Jackson, TN
  • NPI 1093705428
  Care Compare affiliation

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

{
    "created_epoch": "1483574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554595200000",
    "number": "1982149621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 UNION AVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383016036",
            "telephone_number": "731-926-0431",
            "fax_number": "731-541-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 WAYNE RD",
            "city": "SAVANNAH",
            "state": "TN",
            "postal_code": "38372",
            "telephone_number": "731-926-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 Skyline Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383013923",
            "country_code": "US",
            "telephone_number": "731-541-7070",
            "fax_number": "731-541-7075",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 Skyline Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383013923",
            "country_code": "US",
            "telephone_number": "731-541-7070",
            "fax_number": "731-541-7075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JACOB",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-05",
        "last_updated": "2019-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "22130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edmund L. Carey Jr., M.D.
• Carroll Pharmacy
• Carroll Pharmacy
• Benjamin Carroll
• David Allen Carroll, DOCTOR OF PHARMACY
• Jana A Carroll
• Betty Amelia Carter, FNP
• Julie Childers, PHARMD
• Brittany Clausel
• Jordan Matthew Clayton, NP-C

• Certified Registered Nurse Anesthetist in Savannah, TN
• Providers in Savannah, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2019; 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.