JAN ELLEN WORTHAM (CRNA) – Certified Registered Nurse Anesthetist, NPI 1629033303
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
716 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in AR
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Provider Addresses for JAN ELLEN WORTHAM (CRNA)
PO BOX 190670
LITTLE ROCK, AR 722190670
Phone: (501) 771-4693
Fax: (501) 771-4885
Type: Mailing
Springhill Drive, North Little Rock, Pulaski County, Arkansas, 72214, United States
NORTH LITTLE ROCK, AR 721172922
Phone: (501) 202-3000
Type: Location
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: 2010-11-16
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20101116000951 | I | Certified Registered Nurse Anesthetist (Crna) | AR | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 00865 | Anesthesia for extensive removal of prostate | 21 | 21 | $0 |
| 00910 | Anesthesia for other procedure on urinary system through urethra | 18 | 14 | $0 |
| 00862 | Anesthesia for procedure on upper urinary tubes or removal of kidney for transplant | 17 | 17 | $0 |
Insurance plans in this area (ZIP 72219)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AR | |
| - | AR | |
| - | AR | |
| Diagnostic Radiology, Interventional Radiology | AR | |
| - | AR | |
| - | AR | |
| - | AR | |
| Certified Registered Nurse Anesthetist (Crna) | AR | |
| Certified Registered Nurse Anesthetist (Crna) | AR | |
| Certified Registered Nurse Anesthetist (Crna) | AR |
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