JAKE JOHNSON (NPI# 1548732076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548732076 |
| Entity Type | Individual |
| Full Name | JAKE JOHNSON |
| Credential | CRNA |
| Practice Address |
602 Indiana Ave Lubbock TX 79415-3364 |
| Mailing Address |
531 N Chicago Ave Apt B Lubbock TX 79416-2911 |
| Practice Telephone | 8067758200 |
| Mailing Telephone | 8068817317 |
| Enumeration Date | 2018-12-21 |
| Last Update Date | 2018-12-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 838272 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295333946 | Jake Johnson | Pharmacist | 17008 Palm Pointe Dr, Tampa, FL 33647-3504 | 2020-10-14 |
| 1851939938 | Jake Johnson | Counselor | 3400 W Garland Ave, Spokane, WA 99205-2119 | 2019-12-19 |
| 1225698921 | Jake Nolan Johnson | Internal Medicine | 982055 Nebraska Medical Ctr, Omaha, NE 68198-2055 | 2019-06-17 |
| 1134787518 | Jake Michael Johnson | Physician Assistant | 267 Grant St, Bridgeport, CT 06610-2805 | 2019-05-31 |
| 1144708652 | Jake Johnson | Student in an Organized Health Care Education/Training Program | 812 University St, Pella, IA 50219-1902 | 2018-08-06 |
| 1902086705 | Jake L Johnson IIi | Counselor | 1500 S Mcdonnell Ave, Los Angeles, CA 90040-5623 | 2007-11-08 |
| 1164625240 | Jake A Johnson | Counselor | 14300 Gallant Fox Ln, Suite 211, Bowie, MD 20715-4003 | 2007-06-07 |
| 1043254618 | Jake Carson Johnson | Anesthesiology | 67 Creekside Park Ct, Greenville, SC 29615-4810 | 2006-06-15 |
| Street Address |
602 INDIANA AVE |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79415-3364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487659876 | Mark Brendan Reedy | Obstetrics & Gynecology | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2005-06-14 |
| 1417571613 | Chelsea Brooke Seaton | Student in an Organized Health Care Education/Training Program | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2020-06-03 |
| 1437773728 | John Clinton Fisher IIi | Student in an Organized Health Care Education/Training Program | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2020-06-02 |
| 1700409448 | Ryan Everett Hirata | Student in an Organized Health Care Education/Training Program | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2020-05-28 |
| 1013530716 | Lillian Amezquita | Student in an Organized Health Care Education/Training Program | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2020-05-28 |
| 1457990186 | Madison Dreu Williams | Registered Nurse | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-12-28 |
| 1972145977 | Alicia Garcia Castanon | Nurse Practitioner | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-10-10 |
| 1770133746 | Candace Kernell | Registered Nurse | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-09-12 |
| 1154883767 | James William Woodwick Jr. | Nurse Practitioner | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-04-02 |
| 1811455066 | Rolando Adolfo Lugo II | Nurse Practitioner | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831569540 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3502 9th St Ste 280, Lubbock, TX 79415 | 2015-10-07 |
| 1922447457 | Fnu Parijat Kumar | Physical Therapist | 2717 3rd Street, Aptt 803, Lubbock, TX 79415 | 2013-06-18 |
| 1851575906 | Diego Rivera, M.d., P.a. | Family Medicine | 111 University Ave, Lubbock, TX 79415 | 2007-12-26 |
| 1730206632 | Kathleen Brinkman Felts | Physical Therapist | 3710 4th Street, Lubbock, TX 79415 | 2007-03-23 |
| 1568508521 | Horace Rueben Sharp Jr. | Optometrist | 1911 4th St, Lubbock, TX 79415 | 2007-01-29 |
| 1699876201 | Patricia R. Arledge | Plastic Surgery | 3502 9th St., Suite 270, Lubbock, TX 79415 | 2006-09-26 |
| 1245330018 | Perlita Molina Sambrano-tandoc | Nurse Practitioner | 602 East Indiana Avenue, Lubbock, TX 79415 | 2006-09-22 |
| 1639199862 | Justin Tidwell | Emergency Medicine | 604 Indiana, Lubbock, TX 79415 | 2006-07-20 |
| 1912944059 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3301 Clovis Road, Lubbock, TX 79415 | 2006-05-31 |
| 1497709265 | Byron Wayne Schoettle | Radiology | 602 Indiana Avenue, Lubbock, TX 79415 | 2006-05-19 |
| Find all providers in zip 79415 | ||||
| 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 |
|---|---|---|---|---|
| 1669038626 | Hub City Anesthesia | Nurse Anesthetist, Certified Registered | 3416 22nd Street, Lubbock, TX 79410 | 2019-05-15 |
| 1013489764 | Nzonguti Ekangaki | Nurse Anesthetist, Certified Registered | 3601 4th St Ste 1b350s, Lubbock, TX 79430-0002 | 2018-12-19 |
| 1154838241 | Tracy Danielle Mill | Nurse Anesthetist, Certified Registered | 3601 4th Street Suite 1b350s, Lubbock, TX 79430-0001 | 2018-01-10 |
| 1982149076 | Elliot Michel | Nurse Anesthetist, Certified Registered | 3601 4th St # 1b350s, Lubbock, TX 79430-0002 | 2016-12-27 |
| 1023377207 | Joshua Kain Jones | Nurse Anesthetist, Certified Registered | 5602 Geneva Ave, Lubbock, TX 79413-4824 | 2012-05-09 |
| 1336408681 | Stephen Creighton Ray | Nurse Anesthetist, Certified Registered | 2400 Glenna Goodacre Blvd Apt 4326, Lubbock, TX 79401-2280 | 2012-05-07 |
| 1952606667 | David Irvin | Nurse Anesthetist, Certified Registered | 3610 22nd St, Lubbock, TX 79410-1350 | 2011-01-12 |
| 1023313673 | Mayme Alicia Matthews | Nurse Anesthetist, Certified Registered | Texas Tech University Health Sciences Ctr, 3601 4th Street, Ms 8182, Lubbock, TX 79430-0001 | 2011-01-12 |
| 1992941082 | Keila H Townson | Nurse Anesthetist, Certified Registered | 5020 Auburn St, Apt 1012, Lubbock, TX 79416 | 2008-12-19 |
| 1972548428 | Isagani L. Saculo | Nurse Anesthetist, Certified Registered | 4315 28th St Suite 2, Suite 1c282, Lubbock, TX 79410-2507 | 2006-06-18 |
| Find all providers in LUBBOCK | ||||
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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.