JESSE B JOHNSON (CRNA) – Certified Registered Nurse Anesthetist, NPI 1619975455

Certified Registered Nurse Anesthetist

JESSE B JOHNSON (CRNA) is a healthcare provider. based in Texarkana, Texas. specializing in Certified Registered Nurse Anesthetist. They hold the professional credentials CRNA. They hold a License No. 621415 (TX). The NPI Number for JESSE B JOHNSON (CRNA) is 1619975455

Main info

Male

29 Years Of Experience

Accepts Medicare Assignment

Name

JESSE B JOHNSON (CRNA)

NPI

1619975455

Phone

(903) 735-9802

Address

4100 SUMMERHILL RD

Enumeration Date

13 July 2005

Last Update Date

30 October 2024

Doctor Profile

Medical School Name

OTHER

Secondary Phone

9726088000

Graduation Year

1997 (29 years ago)

PAC ID

5496941593

Group Practice PAC ID

7315907128

Professional Enrollment ID

I20101201000987

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience73

Completeness75

Years active:20State licenses:2Digital endpointsOther names

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Provider Addresses for JESSE B JOHNSON (CRNA)

4100, Summerhill Road, Texarkana, Bowie County, Texas, 75503, United States
TEXARKANA, TX 755032732
Phone: (903) 735-9802
Fax: (903) 735-9806
Type: Location
PO BOX 583
LOWELL, AR 727450583
Phone: (800) 475-6236
Fax: (903) 787-5854
Type: Mailing
609 W MAPLE AVE
SPRINGDALE, AR 727645335
Phone: (479) 751-5711
Fax: (479) 751-1099
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: 2022-12-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

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
I20101201000987	I	Certified Registered Nurse Anesthetist (Crna)	TX	TBD
I20221205001728	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 75503)

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Provider's Procedures

JESSE B JOHNSON (CRNA) performs procedures in Certified Registered Nurse Anesthetist. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
CERTIFIED REGISTERED NURSE ANESTHET	TX	00142	Anesthesia for lens surgery	48	48
CERTIFIED REGISTERED NURSE ANESTHET	TX	00790	Anesthesia for procedure in upper abdomen including use of an endoscope	14	14

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: 7315907128View full group profile

Name	Specialty	State
LYNN C ANDREWS (CRNA)	Certified Registered Nurse Anesthetist (Crna)	IN
MR. JEROME NAYIGIZIKI (C.R.N.A.)	-	TX
DR. LONG T NGUYEN (MD)	A N E S T H E S I O L O G Y	TX
CARRIE L PIKE (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TX
DR. ROBERT GENE JANTZ (MD)	A N E S T H E S I O L O G Y	TX
DR. BRET RICHARD TODD (DO)	A N E S T H E S I O L O G Y	OH
TAYLOR JOHNSON (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TX
KARLEE PRUITT (RN)	Certified Registered Nurse Anesthetist (Crna)	TX
JOHN L SAWYER (CRNA)	-	TX
MATTHEW LEWIS HYATT (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TX

Reviews

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Frequently asked questions

Does JESSE B JOHNSON (CRNA) have a public NPI I can cite?

Public records show JESSE B JOHNSON (CRNA) under NPI 1619975455.

Is JESSE B JOHNSON (CRNA)'s NPI status active today?

Active status means JESSE B JOHNSON (CRNA)'s NPI record is not deactivated in the public file.

What services align with JESSE B JOHNSON (CRNA)'s listing?

JESSE B JOHNSON (CRNA)'s public classification highlights Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.

Is JESSE B JOHNSON (CRNA) tied to Texarkana, Texas?

If you are local to Texarkana, Texas, JESSE B JOHNSON (CRNA) may be relevant to your search.

What is the difference between NPI and a medical license?

An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.