JORDAN D BLACKWILL (NPI# 1992191225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992191225 |
| Entity Type | Individual |
| Full Name | JORDAN D BLACKWILL |
| Credential | CRNA |
| Practice Address |
6901 N 72nd St Omaha NE 68122-1709 |
| Mailing Address |
16478 Erskine St Omaha NE 68116-2523 |
| Practice Telephone | 4025722121 |
| Mailing Telephone | 4027795870 |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2015-04-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 367500000X | Nurse Anesthetist, Certified Registered | D139751 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 68419 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6901 N 72ND ST |
| City | OMAHA |
| State | NE |
| Zip Code | 68122-1709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386641686 | Paul L. Price | Pharmacist | 6901 N 72nd St, Omaha, NE 68122-1709 | 2005-06-30 |
| 1205436896 | Jennifer S Bostick | Counselor | 6901 N 72nd St, Omaha, NE 68122-1709 | 2020-11-01 |
| 1861028847 | Ryan Pirraglia | Nurse Practitioner | 6901 N 72nd St, Omaha, NE 68122-1709 | 2020-03-21 |
| 1417507260 | Stacey M Samuel | Physician Assistant | 6901 N 72nd St, Omaha, NE 68122-1709 | 2019-09-13 |
| 1861041238 | Jonathan Robbins | Nurse Practitioner | 6901 N 72nd St, Omaha, NE 68122-1709 | 2019-09-09 |
| 1114408531 | Nicole M Anthony | Nurse Practitioner | 6901 N 72nd St, Omaha, NE 68122-1709 | 2018-08-23 |
| 1144746322 | Nicole M Privitera | Nurse Practitioner | 6901 N 72nd St, Omaha, NE 68122-1709 | 2017-08-18 |
| 1588196299 | Felina Brown | Nurse Practitioner | 6901 N 72nd St, Attn: Hospital Medicine Dept., Omaha, NE 68122-1709 | 2017-03-31 |
| 1851846380 | Jacqueline Jaramillo | Nurse Practitioner | 6901 N 72nd St, Omaha, NE 68122-1709 | 2016-08-25 |
| 1942755954 | Date Amouzou | Nurse Practitioner | 6901 N 72nd St, Omaha, NE 68122-1709 | 2016-08-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609282920 | Andre Jordan | Registered Nurse | 7215 N. 90th Street, Omaha, NE 68122 | 2014-07-08 |
| 1063748895 | Amy Kristine Jones | Speech-Language Pathologist | 703 Country View Dr, Champaign, IL 68122 | 2009-10-29 |
| 1992964100 | Alegent Health Immanuel Medical Center | Psychiatric Residential Treatment Facility | 6845 N 68th Plaza, Omaha, NE 68122 | 2008-06-03 |
| 1093835852 | Suzane Lynne Bohlen | Nurse Anesthetist, Certified Registered | 6901 N 72 St, Omaha, NE 68122 | 2007-03-29 |
| 1376686733 | Midwest Surgical Associates PC | Surgery | 6828 N 72 St, #5500, Omaha, NE 68122 | 2007-02-15 |
| 1902975386 | Midwest Medical Imaging Center Inc | Radiology | Midwest Medical Imaging Center, 6901 North 72nd Street, Omaha, NE 68122 | 2006-11-07 |
| 1245348754 | Scott Denman Wilt | Anesthesiology | 6901 N 72 Street, Omaha, NE 68122 | 2006-08-25 |
| 1982620639 | Robert J Zadalis | Surgery | 6829 N 72nd St Ste 5500, Omaha, NE 68122 | 2006-07-14 |
| 1245299304 | Kristin Nicole Krobot | Physician Assistant | 6901 N. 72nd St., Immanuel Emergency Room, Omaha, NE 68122 | 2006-03-18 |
| 1326575440 | Kathleen L Koeppel | Registered Nurse | 6901 N 72nd Street, Attn: Diabetic Education, Omaha, NE 68122 | 2017-05-19 |
| Find all providers in zip 68122 | ||||
| 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 |
|---|---|---|---|---|
| 1972997062 | Kellyn Nieland | Nurse Anesthetist, Certified Registered | 5913 N 166th Ct, Omaha, NE 68116-3715 | 2015-03-26 |
| 1376961706 | Jennifer Kjolhede | Nurse Anesthetist, Certified Registered | 15435 Douglas Cir, Omaha, NE 68154-2051 | 2014-04-02 |
| 1629205521 | Amy L Bierbaum | Nurse Anesthetist, Certified Registered | 988102 Nebraska Medical Cener, Omaha, NE 68198-0001 | 2009-06-18 |
| 1003051970 | Dorothy Valasek Adley | Nurse Anesthetist, Certified Registered | 8051 West Center Rd., Omaha, NE 68124 | 2008-12-08 |
| 1407010796 | Emily Joan Glaser | Nurse Anesthetist, Certified Registered | Unmc Department of Anesthesiology, 984455 Nebraska Medical Center, Omaha, NE 68198-4455 | 2008-07-15 |
| 1821110339 | Robert C. Wells | Nurse Anesthetist, Certified Registered | 714 Ridgewood Ave, Omaha, NE 68114-5360 | 2007-04-04 |
| 1093835852 | Suzane Lynne Bohlen | Nurse Anesthetist, Certified Registered | 6901 N 72 St, Omaha, NE 68122 | 2007-03-29 |
| 1578635942 | James Franklin Sorrell II | Nurse Anesthetist, Certified Registered | University of Nebraska Medical Ctr, 600 South 42nd Street, Omaha, NE 68198-0001 | 2006-11-14 |
| 1518059393 | Marcia Ann Jensen | Nurse Anesthetist, Certified Registered | 8711 N 57th St, Omaha, NE 68152-1714 | 2006-09-29 |
| 1811001597 | Michele C. Gengler | Nurse Anesthetist, Certified Registered | 8303 Dodge Street, Omaha, NE 68114 | 2006-08-18 |
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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.