| Dr Jared T Holton, CRNA | |
|
6800 State Route 162, Maryville, IL 62062-8500 | |
| (800) 281-3903 | |
| Not Available |
| Full Name | Dr Jared T Holton |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 7 Years |
| Location | 6800 State Route 162, Maryville, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194210393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 209.017838 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Lukes Hospital | Chesterfield, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Comprehensive Anesthesia Care Pc | 5799698551 | 54 |
| Entity Name | Comprehensive Anesthesia Care Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215975156 PECOS PAC ID: 5799698551 Enrollment ID: O20031107000275 |
| Entity Name | Cpr Anesthesia Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326436353 PECOS PAC ID: 7416272927 Enrollment ID: O20200625003307 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jared T Holton, CRNA 1130 Century Dr Ste E, Edwardsville, IL 62025-3699 Ph: (618) 971-7919 | Dr Jared T Holton, CRNA 6800 State Route 162, Maryville, IL 62062-8500 Ph: (800) 281-3903 |
Michael Petru, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 6810 State Route 162, Suite 215, Maryville, IL 62062 Phone: 618-288-5711 | |
Michael Southwick, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 6810 State Route 162, Ste 215, Maryville, IL 62062 Phone: 618-288-5711 | |
Ms. Connie Ann Dumm, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 6800 State Route 162, Maryville, IL 62062 Phone: 618-288-5711 | |
Joseph Hines, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 6810 State Route 162, Ste 215, Maryville, IL 62062 Phone: 618-288-5711 | |
Mark Silvey, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 6810 State Route 162, Suite 215, Maryville, IL 62062 Phone: 618-288-5711 | |
Sherri Blaha, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 6810 State Route 162, Suite 215, Maryville, IL 62062 Phone: 618-288-5711 |