RANDY JACKSON CRNA
NPI 1407470719
Nurse Anesthetist, Certified Registered in Jackson, OH

Q: What is Randy Jackson's NPI number?

The NPI number for Randy Jackson is 1407470719. It was assigned to this individual provider in the NPPES registry on June 2, 2020.

Q: What is Randy Jackson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Randy Jackson was last updated on January 21, 2021. 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.

Active since June 02, 2020Accepts Medicare Assignment

81.42/100

CMS Quality Rating

280 PATTONSVILLE RD, JACKSON, OH 45640(740) 446-5000 Get Directions Write a Review

NPPES record last updated: January 21, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 21, 2021, Jul 7, 2020, Jun 2, 2020 (3 updates tracked since 2020).

On this page

About Randy Jackson Crna NPPES

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

RANDY JACKSON CRNA (NPI 1407470719) is an individual nurse anesthetist, certified registered in Jackson, Ohio, licensed in Ohio (APRN.CRNA.0020099) and active in the NPI registry since June 2020. He is affiliated with Holzer Medical Center and is a graduate of Jc Edwards School Of Medicine, Marshall University (2020).

NPPES Registry Identity

NPI1407470719

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameRANDY JACKSONCredential: CRNA

Location Address280 PATTONSVILLE RDJackson, OH 45640-9452

Mailing Address90 Jackson PikeGallipolis, OH 45631-1560 · (740) 446-5387

Phone(740) 446-5000

Sole ProprietorNo

Medical School CMSJc Edwards School Of Medicine, Marshall UniversityGraduated 2020

Enumeration DateJune 2, 2020

Last NPPES UpdateJanuary 21, 20213 updates tracked since enumeration

NPPES CertifiedJanuary 21, 2021

✔ NPI 1407470719 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 OH · APRN.CRNA.0020099

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.

280 PATTONSVILLE RD, Jackson, OH 45640

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Other Identifiers 1

Medicaid0408956OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Oscar Health Insurance.Insurance ›

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

Randy Jackson 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 ID4183047327

PECOS Enrollment IDI20200707002719

Hospital Affiliations CMS Care Compare

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

Holzer Medical Center

Acute Care Hospitals · Gallipolis, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360054

Location100 Jackson PikeGallipolis, OH 45631 · Gallia County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45640 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

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

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.

81.42/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

69.28

Promoting Interoperability

100

Improvement Activities

Cost

57.96

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.

BREANNA MORGAN CNP

Family Medicine