KRISTINA GAYLE JACKSON (NPI# 1558684183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558684183 |
| Entity Type | Individual |
| Full Name | KRISTINA GAYLE JACKSON |
| Credential | C.R.N.A. |
| Practice Address |
755 N 11th St Suite P3600 Beaumont TX 77702-1500 |
| Mailing Address |
Po Box 5587 Beaumont TX 77726-5587 |
| Practice Telephone | 4098385214 |
| Mailing Telephone | 4098385214 |
| Enumeration Date | 2010-03-10 |
| Last Update Date | 2015-02-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN0000142813 | TN | Nursing Service Providers |
| Y | 367500000X | Nurse Anesthetist, Certified Registered | APN 15075 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BLUE CROSS OF TN | 4266382 | 01 |
| TN | CHAMPUS/HUMANA TRICARE | 1558684183 | 01 |
| TN | 1521274 | 05 | |
| TN | RAILROAD MEDICARE | P00907129 | 01 |
| MS | 07805512 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447600770 | Kristina Jackson | Counselor | 5160 Dogwood Trl, Eight Mile, AL 36613-8505 | 2016-06-17 |
| 1083042345 | Kristina Yvette Jackson | Technician/Technologist | 16770 Pheasant Trail Pl, Strongsville, OH 44136-6369 | 2013-10-24 |
| 1235616863 | Kristina Jackson | Counselor | 762 Transfer Rd Ste 21, Saint Paul, MN 55114-1489 | 2018-07-26 |
| 1023477114 | Kristina Jackson | Marriage & Family Therapist | 2309 Pacific Coast Hwy, Suite 102, Hermosa Beach, CA 90254-2751 | 2016-02-17 |
| 1689010738 | Kristina E Jackson | Family Medicine | 1501 Ne Medical Center Dr, Bend, OR 97701-6051 | 2013-05-16 |
| 1184966087 | Kristina Jackson | Counselor | 1800 Mercy Dr, Suite 302, Orlando, FL 32808-5646 | 2013-03-19 |
| 1225391006 | Kristina Ashley Jackson | Social Worker | 2928 W 36th St, Brooklyn, NY 11224-1410 | 2012-06-18 |
| 1780990531 | Kristina Janet Jackson | Student in an Organized Health Care Education/Training Program | 1145 Gayley Ave, Suite 322, Los Angeles, CA 90024-3423 | 2010-08-30 |
| 1740350586 | Kristina G Jackson | Family Medicine | 480 Maple St, Danvers, MA 01923 | 2006-11-09 |
| 1821061474 | Kristina M Jackson | Audiologist | 4600 Main St, Suite 201, Amherst, NY 14226-4500 | 2006-02-13 |
| Street Address |
755 N 11TH ST SUITE P3600 |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77702-1500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841293909 | Alfred B. Brady Jr. | Internal Medicine | 755 N 11th St, Ste P2200, Beaumont, TX 77702-1500 | 2005-05-23 |
| 1285171256 | Lance T. Mendoza | Nurse Anesthetist, Certified Registered | 755 N 11th St, Suite P3600, Beaumont, TX 77702-1500 | 2017-01-27 |
| 1235676487 | Brittany Syphrett | Nurse Practitioner | 755 N 11th St, Suite P-5200, Beaumont, TX 77702-1500 | 2017-01-26 |
| 1164974705 | Fidel Gonzalez | Nurse Practitioner | 755 N 11th St, Suite P-3950, Beaumont, TX 77702-1500 | 2016-10-31 |
| 1417409285 | Beaumont Asc, Lp | Clinic/Center | 755 N 11th St, Suite P3970b, Beaumont, TX 77702-1500 | 2016-10-27 |
| 1568816098 | Stephanie Angela Williams | Nurse Practitioner | 755 N 11th St, Suite P5200, Beaumont, TX 77702-1500 | 2016-04-21 |
| 1578931598 | Florencia Espinal | Nurse Anesthetist, Certified Registered | 755 N 11th St, Suite P3600, Beaumont, TX 77702-1500 | 2015-09-08 |
| 1467837088 | Joseph Brottem, Crna | Nurse Anesthetist, Certified Registered | 755 N 11th St, Suite P3600, Beaumont, TX 77702-1500 | 2015-07-24 |
| 1356731129 | John E Hoffpauir | Nurse Anesthetist, Certified Registered | 755 N 11th St, Suite P3600, Beaumont, TX 77702-1500 | 2015-01-30 |
| 1689076549 | Lauren Jordan Barrera | Nurse Practitioner | 755 N 11th St, Suite P5200, Beaumont, TX 77702-1500 | 2014-09-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346871134 | Anne Parker Chen | Psychologist | 2431 Liberty St., Beaumont, TX 77702 | 2020-01-30 |
| 1841715299 | Encounter Home Care, Inc. | Home Health | 990 I H 10 North, 225, Beaumont, TX 77702 | 2017-08-07 |
| 1962860023 | Jennifer Abney Bell | Nurse Practitioner | 3030 North St., Suite 510, Beaumont, TX 77702 | 2016-02-04 |
| 1720407687 | Jennifer Huff | Nurse Practitioner | 2980 Calder Ave, Beaumont, TX 77702 | 2014-04-08 |
| 1669894580 | Julie Christine Makdsi | Psychologist | 80 Interstate 10 N., Suite 205, Beaumont, TX 77702 | 2014-01-11 |
| 1437586682 | Lori Wenner | Registered Nurse | 2410 Harrison Street, Beaumont, TX 77702 | 2013-10-02 |
| 1548503311 | Robert J Grammatico | Emergency Medicine | 2830 Calder Ave., Beaumont, TX 77702 | 2013-03-30 |
| 1396084992 | Courtney Marie Guidry | Physician Assistant | 755 N 11th St Ste P5200, Beaumont, TX 77702 | 2013-02-04 |
| 1043524788 | Swarnalatha Devi Bathina | Dentist | 490 Ih-10, Suite 200, Beaumont, TX 77702 | 2010-08-05 |
| 1376798884 | Rehana Haq Javed | Pathology | Christus Hospital 2830 Calder St., Beaumont, TX 77702 | 2008-11-25 |
| Find all providers in zip 77702 | ||||
| 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 |
|---|---|---|---|---|
| 1609314517 | Jonathan Michael Cotteen | Nurse Anesthetist, Certified Registered | 35295 Stockton St, Beaumont, CA 92223-6228 | 2017-02-10 |
| 1104986199 | Robert Foreman | Nurse Anesthetist, Certified Registered | 755 N 11th St Ste P3600, Beaumont, TX 77702-1515 | 2006-12-11 |
| 1396775755 | Linda Gayle Sanders | Nurse Anesthetist, Certified Registered | 755 N. 11th Street, Suite P3600, Beaumont, TX 77726-5587 | 2006-07-03 |
| 1679557888 | Christus Health Southeast Texas | Nurse Anesthetist, Certified Registered | 2830 Calder St, Administration, Beaumont, TX 77702-1809 | 2005-12-01 |
| 1952309452 | Thomas E. York | Nurse Anesthetist, Certified Registered | 4215 N Major Dr, Apt 609, Beaumont, TX 77713-9611 | 2005-07-08 |
| 1912903055 | Gregory Todd Parkhurst | Nurse Anesthetist, Certified Registered | 950 N 14th St Ste 100, Beaumont, TX 77702-1112 | 2005-06-23 |
| 1134742885 | Kenneth Dale Simmons IIi | Nurse Anesthetist, Certified Registered | 755 N 11th St Ste P3600, Beaumont, TX 77702-1515 | 2020-05-28 |
| 1043839624 | Ashley Lynn Billot | Nurse Anesthetist, Certified Registered | 2830 Calder St, Beaumont, TX 77702-1809 | 2020-04-13 |
| 1972133668 | Kathryn C. Taylor | Nurse Anesthetist, Certified Registered | 755 N 11th St Ste P3600, Beaumont, TX 77702-1515 | 2020-01-22 |
| 1477078202 | Anesthesia Associates Group Pllc | Nurse Anesthetist, Certified Registered | 755 N 11th St Ste P3600, Beaumont, TX 77702-1515 | 2017-08-14 |
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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.