MR. JACK B WATERS CRNA
NPI 1407152358
Nurse Anesthetist, Certified Registered in Saint George, UT

Active since February 09, 2011Accepts Medicare Assignment
2365 E SEGOVIA DR, SAINT GEORGE, UT 84790(435) 773-5585 Get Directions Write a Review

NPPES record last updated: December 20, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Jack B Waters Crna NPPES

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

MR. JACK B WATERS CRNA (NPI 1407152358) is an individual nurse anesthetist, certified registered in Saint George, Utah, licensed in Oregon (201160004CRNA) and active in the NPI registry since February 2011. He is a graduate of Other (2010).

NPPES Registry Identity

NPI1407152358
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameMR. JACK B WATERSCredential: CRNA
Location Address2365 E SEGOVIA DRSaint George, UT 84790-7487
Mailing Address2365 E Segovia DrSaint George, UT 84790-7487 · (435) 773-5585
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateFebruary 9, 2011
Last NPPES UpdateDecember 20, 2021
NPPES CertifiedDecember 20, 2021
NPI 1407152358 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 OR · 201160004CRNA
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.

2365 E SEGOVIA DR, Saint George, UT 84790

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mr. Jack B Waters 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 ID1557534989
PECOS Enrollment IDI20201104002900

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84790 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
$125.70 typical visit price
range $54.34 – $166.03
Typical copayment $31.42 (range $13.58 – $41.50)
Most-billed visit code 99204
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Pre-operative OSA assessment
Percentage of patients who undergo a surgical procedure in the operating room/procedure room that have a pre-operative assessment for Obstructive Sleep Apnea (OSA)
78%1,330 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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 Jack Waters's NPI number?

The NPI number for Jack Waters is 1407152358. It was assigned to this individual provider in the NPPES registry on February 9, 2011.

Where is Jack Waters located?

Jack Waters practices at 2365 E Segovia Dr, Saint George, UT 84790. The listed phone number is (435) 773-5585.

What is Jack Waters's specialty?

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

Is Jack Waters enrolled in Medicare?

Yes. Jack Waters 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.

When was this NPI record last updated?

The NPPES record for Jack Waters was last updated on December 20, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.