MR. MARK WAYNE JACKSON (CRNA) – Certified Registered Nurse Anesthetist, NPI 1043438443
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,370 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in KY
Provider Addresses for MR. MARK WAYNE JACKSON (CRNA)
350 PARK ST
SUITE 203B
BOWLING GREEN, KY 421011784
Phone: (270) 393-1912
Type: Mailing
68 S SERVICE RD STE 350
MELVILLE, NY 117472358
Phone:
Type: Mailing
1901 CLINCH AVE
KNOXVILLE, TN 379162307
Phone: (865) 331-1111
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $23.
Total Amount is formed as General ($23) + Research ($0) + Ownership ($0) = $23.
Last reported payment date: 2023-07-06 • Largest payer in this snapshot: Alpha Orthopedic Systems ($23).
Total Amount
$23
General + Research + Ownership
Payments
1
Total payment records
General Amount
$23
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-07-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alpha Orthopedic Systems | $23 |
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: 2021-03-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 7 Medicare enrollment records; no due dates published yet.
Enrollment records
7
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 |
|---|---|---|---|---|
| I20051214000106 | I | Certified Registered Nurse Anesthetist (Crna) | TN | TBD |
| I20090630000370 | I | Certified Registered Nurse Anesthetist (Crna) | KY | TBD |
| I20180815002219 | I | Certified Registered Nurse Anesthetist (Crna) | AL | TBD |
| I20190715002812 | I | Certified Registered Nurse Anesthetist (Crna) | WI | TBD |
| I20190917001215 | I | Certified Registered Nurse Anesthetist (Crna) | TX | TBD |
| I20200123002094 | I | Certified Registered Nurse Anesthetist (Crna) | NM | TBD |
| I20210317001432 | I | Certified Registered Nurse Anesthetist (Crna) | VA | 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 |
|---|---|---|---|---|
| 00142 | Anesthesia for lens surgery | 40 | 35 | $0 |
| 00812 | Anesthesia for exam of colon using an endoscope | 29 | 29 | $0 |
| 01402 | Anesthesia for procedure for total knee joint replacement | 23 | 23 | $0 |
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 17 | 17 | $0 |
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 15 | 15 | $0 |
Insurance plans in this area (ZIP 42101)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| CERTIFIED REGISTERED NURSE ANESTHET | KY | 31500 | Emergent insertion of breathing tube into windpipe cartilage using an endoscope | 11 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | OH | |
| Internal Medicine | WI | |
| H O S P I T A L I S T | MD | |
| Nurse Practitioner | KY | |
| O B S T E T R I C S/ G Y N E C O L O G Y | KY | |
| Internal Medicine | KY | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| Internal Medicine | IN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | KY |
Reviews
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