KELSEY C JACKS (CRNA) – Certified Registered Nurse Anesthetist, NPI 1770254963

KELSEY C JACKS (CRNA) is a healthcare provider. based in Calera, Alabama. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 1161964 (AL). The NPI Number for KELSEY C JACKS (CRNA) is 1770254963

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
KELSEY C JACKS (CRNA)
NPI
1770254963
Phone
(205) 617-4010
Address
116 GRANT CIR
Enumeration Date
27 September 2021
Last Update Date
8 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2057230088
Graduation Year
2024 (2 years ago)
PAC ID
8325572456
Group Practice PAC ID
7012819436
Professional Enrollment ID
I20241113000144
Address ID
AL352161896VE200XXHWYX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:4State licenses:1Digital endpointsOther names

1,625 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in AL

Provider Addresses for KELSEY C JACKS (CRNA)

  • 116 GRANT CIR

    CALERA, AL 350405574

    Phone: (205) 617-4010

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241113000144ICertified Registered Nurse Anesthetist (Crna)ALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35040)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012819436View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)AL
Physician AssistantAL
Nurse PractitionerAL
Pain Management, AnesthesiologyAL
Certified Registered Nurse Anesthetist (Crna)AL
Physician AssistantAL
Certified Registered Nurse Anesthetist (Crna)AL
Certified Registered Nurse Anesthetist (Crna)AL
Interventional Pain Management, Pain ManagementAL

Reviews

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Frequently asked questions

How do payers reference KELSEY C JACKS (CRNA)?
For KELSEY C JACKS (CRNA), use NPI 1770254963 as the unique 10-digit identifier.
Active or inactive — what applies to KELSEY C JACKS (CRNA)?
You should see KELSEY C JACKS (CRNA) as active in CMS-hosted NPPES data.
What area of care is associated with KELSEY C JACKS (CRNA)?
KELSEY C JACKS (CRNA)'s record emphasizes Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Is KELSEY C JACKS (CRNA) associated with Calera?
Public fields place KELSEY C JACKS (CRNA) around Calera, Alabama. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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