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JACOB PAULK CRNA
NPI 1215227202
Nurse Anesthetist, Certified Registered in Tifton, GA

Active since April 12, 2011Accepts Medicare Assignment
901 18TH ST E, TIFTON, GA 31794(229) 353-6124(229) 353-7722 Get Directions Write a Review

NPPES record last updated: December 16, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jacob Paulk Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB PAULK CRNA (NPI 1215227202) is an individual nurse anesthetist, certified registered in Tifton, Georgia, licensed in Georgia (RN181759) and active in the NPI registry since April 2011. He is affiliated with Coffee Regional Medical Center, Inc and is a graduate of Other (2010).

NPPES Registry Identity

NPI1215227202
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameJACOB PAULKCredential: CRNA
Location Address901 18TH ST ETifton, GA 31794-3648
Mailing Address209 Tillman Paulk RdAmbrose, GA 31512-3486 · (229) 548-5137
Phone(229) 353-6124
Fax(229) 353-7722
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateApril 12, 2011
Last NPPES UpdateDecember 16, 2020
NPPES CertifiedDecember 16, 2020
✔ NPI 1215227202 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in GA · RN181759
Definition
(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.
901 18TH ST E, Tifton, GA 31794
Open in Google Maps ↗

Other Identifiers 1

OtherRN181759GA · State License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacob Paulk Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062687312
PECOS Enrollment IDI20111214000879

Medicare Billing Reassignments

4

Medicare enrollment records show Jacob Paulk reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Coffee Regional Medical Center, Inc
37 mi
Anesthesiology
1101 OCILLA RD
Douglas, GA 31533
  • Reassigned Medicare billing, Georgia enrollment
  • 72 clinicians in this Medicare group
NPI 1437120946 (912) 384-1900
Southern Sleepers Anesthesia LLC
37 mi
Nurse Anesthetist, Certified Registered
300 SHIRLEY AVE
Douglas, GA 31533
  • Reassigned Medicare billing, Georgia enrollment
  • 5 clinicians in this Medicare group
NPI 1720520646 (229) 469-7653
Sweet Dreams Anesthesiology Nurses Of Georgia LLC
95 mi
Nurse Anesthetist, Certified Registered
577 MULBERRY ST STE 110
Macon, GA 31201
  • Reassigned Medicare billing, Georgia enrollment
  • 91 clinicians in this Medicare group
NPI 1669737409 (888) 728-0882
Sweet Dreams Nurse Anesthesia, Inc.
186 mi
Nurse Anesthetist, Certified Registered
4080 MCGINNIS FERRY RD STE 102
Alpharetta, GA 30005
  • Reassigned Medicare billing, Georgia enrollment
  • 82 clinicians in this Medicare group
NPI 1649463365 (888) 728-0882

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731
This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.
11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Coffee Regional Medical Center, Inc

Acute Care Hospitals · Douglas, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110089
Location1101 Ocilla RoadDouglas, GA 31533 · Coffee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31794 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COLE BURGESS CRNA
Nurse Anesthetist, Certified Registered
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-6124
ISRAEL SAUCEDO APRN, FNP-C
Nurse Practitioner (Acute Care)
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-7050
JAVERIA NASEER MBBS
Student in an Organized Health Care Education/Training Program
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 382-7120
WILLIAM A GUEST MD
Internal Medicine (Pulmonary Disease)
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-3400
JOSE ABANTAO PT
Physical Therapist
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-3347
DR. KAMRAN LATEEF MD
Internal Medicine
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-6051
HEATH FARMER CRNA
Nurse Anesthetist, Certified Registered
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-6124
DAVID RYAN ATKINS APRN-BC
Nurse Practitioner (Family)
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 382-7120

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Paulk's NPI number?

The NPI number for Jacob Paulk is 1215227202. It was assigned to this individual provider in the NPPES registry on April 12, 2011.

Where is Jacob Paulk located?

Jacob Paulk practices at 901 18th St E, Tifton, GA 31794. The listed phone number is (229) 353-6124.

What is Jacob Paulk's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Jacob Paulk enrolled in Medicare?

Yes. Jacob Paulk is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jacob Paulk's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Paulk reassigns Medicare benefits to 4 organizations: Coffee Regional Medical Center, Inc (Douglas, GA), Southern Sleepers Anesthesia LLC (Douglas, GA), Sweet Dreams Anesthesiology Nurses Of Georgia LLC (Macon, GA) and Sweet Dreams Nurse Anesthesia, Inc. (Alpharetta, GA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacob Paulk's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Jacob Paulk affiliated with any hospitals?

According to CMS data, Jacob Paulk is affiliated with Coffee Regional Medical Center, Inc.

When was this NPI record last updated?

The NPPES record for Jacob Paulk was last updated on December 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.