JACOB PAULK CRNA NPI 1215227202

NPI Information

  • NPI: 1215227202
  • Provider Name: JACOB PAULK, CRNA
  • Classification: Nurse Anesthetist, Certified Registered - 367500000X
  • Entity Type: Individual
  • Address: 901 18TH ST E
    TIFTON, GA
    ZIP 31794
  • Phone: (229) 353-6124

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NPI Details

Jacob Paulk, CRNA is a nurse anesthetist certified registered in Tifton, GA with 16 years of experience. The provider is (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. Jacob Paulk, CRNA NPI is 1215227202. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

901 18TH ST E
TIFTON, GA
ZIP 31794-648
Phone: (229) 353-6124
Fax: (229) 353-7722

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope (HCPCS:00731)
  • Anesthesia for lens surgery (HCPCS:00142)

The enumeration date for this NPI number is 4/12/2011 and was last updated on 12/16/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1367500000XNurse Anesthetist, Certified RegisteredRN181759GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1RN181759OTHERGEORGIASTATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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