JASON LEE RICKS (CRNA) – Certified Registered Nurse Anesthetist, NPI 1104114073

Certified Registered Nurse Anesthetist

JASON LEE RICKS (CRNA) is a healthcare provider. based in Joplin, Missouri. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 2011020379 (MO). The NPI Number for JASON LEE RICKS (CRNA) is 1104114073

Main info

Male

15 Years Of Experience

Accepts Medicare Assignment

Name

JASON LEE RICKS (CRNA)

NPI

1104114073

Phone

(417) 781-2727

Address

2817 SAINT JOHNS BLVD

Enumeration Date

13 July 2011

Last Update Date

17 February 2012

Doctor Profile

Medical School Name

OTHER

Secondary Phone

4794631000

Graduation Year

2011 (15 years ago)

PAC ID

1759559115

Group Practice PAC ID

6406077460

Professional Enrollment ID

I20141106000822

Address ID

AR727034424FA3215XBLVD500

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience42

Completeness75

Years active:14State licenses:1Digital endpointsOther names

1,775 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MO

Provider Addresses for JASON LEE RICKS (CRNA)

2817 SAINT JOHNS BLVD
ANESTHESIA DEPT
JOPLIN, MO 648041563
Phone: (417) 781-2727
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: 2014-11-06

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

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
I20141106000822	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.

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 64804)

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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: 6406077460View full group profile

Name	Specialty	State
AMANDA LAVON DELSOTO (CRNA)	Certified Registered Nurse Anesthetist (Crna)	MO
MR. TERRY MITCHEL JR. HUGHES (CRNA)	Certified Registered Nurse Anesthetist (Crna)	AR
DR. DUSTIN TAYLOR BRANNON (DNAP-CRNA)	Certified Registered Nurse Anesthetist (Crna)	AR
SHANNON NGUYEN (CRNA)	Certified Registered Nurse Anesthetist (Crna)	MO
GRANT GEBHARDT (BSN, RN)	Certified Registered Nurse Anesthetist (Crna)	AR
DR. WILLIAM LASSITER (MD)	A N E S T H E S I O L O G Y	AR
MRS. JESSICA MARIE BRANDON (CRNA)	Certified Registered Nurse Anesthetist (Crna)	AR
HEATHER PRIBISLAVSKI (CRNA)	-	AR
JEFFREY GOODHART (CRNA)	-	OK
BRANDIE JOLIE COCKRELL (CRNA)	-	AR

Reviews

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Frequently asked questions

How is JASON LEE RICKS (CRNA) identified in CMS data?

CMS-hosted NPPES data lists JASON LEE RICKS (CRNA) with NPI 1104114073.

Is JASON LEE RICKS (CRNA) listed as active for patients and plans?

The listing shows JASON LEE RICKS (CRNA) as active in the NPI system.

What taxonomy line describes JASON LEE RICKS (CRNA)?

For research purposes, treat JASON LEE RICKS (CRNA) as Certified Registered Nurse Anesthetist in this dataset. Clinical services aligned with this taxonomy classification.

What area does JASON LEE RICKS (CRNA) serve?

JASON LEE RICKS (CRNA)'s listing highlights Joplin, Missouri; more addresses can appear in NPPES.

Why does JASON LEE RICKS (CRNA) have multiple addresses?

2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.