JACK GILBERT WEISS (NPI# 1174534754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174534754 |
| Entity Type | Individual |
| Full Name | JACK GILBERT WEISS |
| Credential | CRNA |
| Practice Address |
77 W Forest Ave Suite 207 Flagstaff AZ 86001-1479 |
| Practice Telephone | 9287732505 |
| Practice Fax Number | 9287732504 |
| Mailing Telephone | 9287732505 |
| Mailing Fax Number | 9287732504 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2008-02-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | CRNA0011 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 363242 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699932285 | Jack Phillip Weiss | Dentist | 4704 Cahaba River Rd, Suite 2d, Birmingham, AL 35243-2344 | 2008-05-21 |
| Street Address |
77 W FOREST AVE SUITE 207 |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-1479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235133059 | Gretchen Karr Schaber | Nurse Practitioner | 77 W Forest Ave, Ste 302, Flagstaff, AZ 86001-1481 | 2005-06-09 |
| 1740728088 | Susan Dale Wall | Social Worker | 77 W Forest Ave, Suite 202, Flagstaff, AZ 86001-1479 | 2017-02-07 |
| 1326408527 | Taye Nelson | Nurse Practitioner | 77 W Forest Ave, Suite 304, Flagstaff, AZ 86001-1479 | 2016-03-01 |
| 1639564453 | Mary Elizabeth Smith Iles | Pediatrics | 77 W Forest Ave, Flagstaff, AZ 86001 | 2015-03-30 |
| 1174914915 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 77 W Forest Ave, Flagstaff, AZ 86001-1479 | 2015-02-16 |
| 1699182188 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 77 W Forest Ave, Flagstaff, AZ 86001-1479 | 2014-07-16 |
| 1033538533 | Neina Orrillo | Registered Nurse | 77 W Forest Ave, Suite 207, Flagstaff, AZ 86001 | 2014-04-11 |
| 1720424997 | Meredith Katz Sena | Specialist | 77 W Forest Ave, Ste 301, Flagstaff, AZ 86001-1479 | 2013-05-15 |
| 1669815825 | Lauren Diane Hayward | Pediatrics | 77 W Forest Ave, Suite 304, Flagstaff, AZ 86001-1479 | 2013-04-08 |
| 1548510019 | Mark Daniel Noorlander | Nurse Anesthetist, Certified Registered | 77 W Forest Ave, Suite 207, Flagstaff, AZ 86001-1479 | 2012-09-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
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| 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 |
|---|---|---|---|---|
| 1770846669 | Peter Gilbert Brainard | Nurse Anesthetist, Certified Registered | 77 W Forest Ave Ste 207, Flagstaff, AZ 86001-1483 | 2012-06-17 |
| 1639252125 | Jennifer A Crownhart | Nurse Anesthetist, Certified Registered | 1020 N. San Francisco St., Flagstaff, AZ 86001 | 2006-10-20 |
| 1285240515 | Amika Noel | Nurse Anesthetist, Certified Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-09-22 |
| 1124649389 | Southwest Anesthesia Partners, LLC | Nurse Anesthetist, Certified Registered | 501 N Switzer Canyon Dr, Flagstaff, AZ 86001-4845 | 2020-04-29 |
| 1003268749 | Elizabeth Gilmore | Nurse Anesthetist, Certified Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2016-07-06 |
| 1487018776 | Paul Burgi | Nurse Anesthetist, Certified Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2016-04-12 |
| 1255796454 | Elizabeth Parker | Nurse Anesthetist, Certified Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2015-12-15 |
| 1427487289 | Integrated Anesthesia Services, LLC | Nurse Anesthetist, Certified Registered | 350 N Switzer Canyon Dr, Flagstaff, AZ 86001-4826 | 2013-11-02 |
| 1730429028 | Mandy L Hilgeman | Nurse Anesthetist, Certified Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2013-02-22 |
| 1083958284 | Ophthalmic Anesthesia Services | Nurse Anesthetist, Certified Registered | 350 N Switzer Canyon Dr, Flagstaff, AZ 86001-4826 | 2012-11-12 |
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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.