JARED CROCKER (NPI# 1114442324) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114442324 |
| Entity Type | Individual |
| Full Name | JARED CROCKER |
| Credential | CRNA |
| Practice Address |
910 Wallace Ave Leitchfield KY 42754-2414 |
| Mailing Address |
119 John Austin Ln Mt Washington KY 40047-6349 |
| Practice Telephone | 2702740480 |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2019-02-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 3013154 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
910 WALLACE AVE |
| City | LEITCHFIELD |
| State | KY |
| Zip Code | 42754-2414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538162268 | Joseph C Petrocelli | Surgery | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2005-05-27 |
| 1992306450 | Karen Michelle Manning | Nurse Practitioner | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2020-11-02 |
| 1104454834 | Grayson County Hospital Foundation Inc | Obstetrics & Gynecology | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2020-03-30 |
| 1649743667 | Concord Company of Tennessee Pllc | Physician Assistant | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2019-01-03 |
| 1891267290 | Kristen Russell | Nurse Practitioner | 910 Wallace Ave, Leitchfield, KY 42754 | 2018-12-23 |
| 1265900955 | Callie J Hancock | Nurse Anesthetist, Certified Registered | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2018-11-12 |
| 1568941987 | Robert Wayne Fuller | Physical Therapist | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2018-08-07 |
| 1518332691 | Eric Powell | Physical Therapist | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2015-12-01 |
| 1427434026 | Robert Holland | Nurse Anesthetist, Certified Registered | 910 Wallace Ave, Leitchfield, KY 42754 | 2015-08-05 |
| 1750766077 | Cheri Molloy | Dietitian, Registered | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2015-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750816849 | April Braun | Occupational Therapy Assistant | 121 Byrtle Grove Rd, Leitchfield, KY 42754 | 2017-04-26 |
| 1124429766 | Scott Anthony Gibson | Counselor | 805 Commerce Dr, Leitchfield, KY 42754 | 2014-09-15 |
| 1013328137 | Sandra M Dennis | Counselor | 505 O Riley St, Leitchfield, KY 42754 | 2014-05-12 |
| 1699071258 | Ellen Renae Pharis | Massage Therapist | 205 Fraim St, Leitchfield, KY 42754 | 2011-01-31 |
| 1184664096 | Joseph Michael Harris Jr. | Physical Therapist | 201 South Main Street, Leitchfield, KY 42754 | 2006-06-08 |
| 1689611469 | Joseph Michael Mulligan | Nurse Anesthetist, Certified Registered | 515 Lake Front Rd., Leitchfield, KY 42754 | 2006-06-01 |
| 1407838030 | Lincoln Trail District Health Dept | Public Health or Welfare | 124 E White Oak St, Leitchfield, KY 42754 | 2005-11-18 |
| 1487646527 | Larry Brett Abney | Optometrist | 31 Bobby Bland Way, Leitchfield, KY 42754 | 2005-08-16 |
| 1336142025 | Ted B Rogers | Orthopaedic Surgery | 908 Wallace Ave, Leitchfield, KY 42754 | 2005-05-27 |
| 1912486887 | Jeanette Marie Jacobs | Pediatrics | 901 Wallace Ave, Leitchfield, KY 42754 | 2018-08-10 |
| Find all providers in zip 42754 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689611469 | Joseph Michael Mulligan | Nurse Anesthetist, Certified Registered | 515 Lake Front Rd., Leitchfield, KY 42754 | 2006-06-01 |
| 1366440281 | Susan Kirkwood | Nurse Anesthetist, Certified Registered | 317 N English St, Leitchfield, KY 42754-2228 | 2005-07-13 |
| 1265900955 | Callie J Hancock | Nurse Anesthetist, Certified Registered | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2018-11-12 |
| 1427434026 | Robert Holland | Nurse Anesthetist, Certified Registered | 910 Wallace Ave, Leitchfield, KY 42754 | 2015-08-05 |
| 1033408729 | John Anthony Lyons | Nurse Anesthetist, Certified Registered | 904 Wallace Ave, Leitchfield, KY 42754-1418 | 2011-04-01 |
| 1285960591 | Richelle Lynn Humphrey | Nurse Anesthetist, Certified Registered | 904 Wallace Ave, Leitchfield, KY 42754-1418 | 2009-10-20 |
| 1053596247 | Rodney D Mann | Nurse Anesthetist, Certified Registered | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2008-01-07 |
| 1184703688 | Merry Lynn Green | Nurse Anesthetist, Certified Registered | 904 Wallace Ave, Leitchfield, KY 42754-1418 | 2006-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881224566 | Elizabeth Wynstra | Nurse Anesthetist, Certified Registered | 800 Rose St # N263, Lexington, KY 40536-7001 | 2020-01-22 |
| 1528533031 | Katherine Berning | Nurse Anesthetist, Certified Registered | 3022 Eagle Pass, Louisville, KY 40217-1727 | 2018-10-11 |
| 1487138160 | Appalachian Surgical Anesthesia, LLC | Nurse Anesthetist, Certified Registered | 5000 Ky 321, Prestonsburg, KY 41616 | 2018-09-19 |
| 1861992885 | West Kentucky Anesthesia Associates | Nurse Anesthetist, Certified Registered | 201 Hunting Crk, Paducah, KY 42003-8762 | 2018-02-16 |
| 1144737982 | Carl Edmond Wisecaver | Nurse Anesthetist, Certified Registered | 230 W Main St Ste 200, Danville, KY 40422-1873 | 2018-01-02 |
| 1326559733 | Morgan Ann Baumgartle | Nurse Anesthetist, Certified Registered | Norton Children's Hospital 231 E. Chestnut St, Louisville, KY 40202 | 2017-10-12 |
| 1184162026 | Jenna Mcgovern | Nurse Anesthetist, Certified Registered | 6822 Hillock Ct, Florence, KY 41042-1174 | 2017-02-10 |
| 1447618632 | Anesthesia Services of Kentucky | Nurse Anesthetist, Certified Registered | 210 Harvest Ln, Mount Washington, KY 40047-5814 | 2016-02-03 |
| 1770948507 | Tara Gardner | Nurse Anesthetist, Certified Registered | 9019 Geneva Cir, Prospect, KY 40059-8583 | 2015-12-21 |
| 1013252717 | Middle Tennessee Anesthesia, Pllc | Nurse Anesthetist, Certified Registered | 529 Cap Harlan Road, Tompkinsville, KY 42167 | 2012-12-06 |
| Find all providers with the same taxonomy | ||||
| City | LEITCHFIELD |
| Zip Code | 42754 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.