J & M Anesthesia LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

J & M ANESTHESIA LLC

Practice address

1301 1St St
Kennett, MO 63857-2525

Phone

(573) 686-5550

NPI assigned

Jun 13, 2012

Organization subpart

No

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

Authorized official

Name

John Ricketts, CRNA

Title

MBR

Phone

(573) 686-5550

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339545600000",
    "number": "1992067185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 S MAIN ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015831",
            "telephone_number": "573-686-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 1ST ST",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638572525",
            "telephone_number": "573-686-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J & M ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-06-13",
        "status": "A",
        "authorized_official_last_name": "RICKETTS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MBR",
        "authorized_official_telephone_number": "573-686-5550",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarissa Ibarra, COTA/L
• Maria Ibarra, LMSW
• Camille Isaacson
• Eugenia Rena Isbell
• Brandala Ivory
• Rosetta Jackson-White
• Brian Jackson
• Cally Anne Jackson
• Holly Jackson
• Jennifer Jackson

• Certified Registered Nurse Anesthetist in Kennett, MO
• Providers in Kennett, MO by specialty
• Certified Registered Nurse Anesthetist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.