Ethan Jackson
NPI 1376348185 · Certified Registered Nurse Anesthetist · Plymouth, MN
Enrolled with Medicare as Practitioner - Certified Registered Nurse Anesthetist (crna) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ethan Jackson is a Certified Registered Nurse Anesthetist provider in Plymouth, MN (NPI 1376348185).
Provider details
- NPI number
- 1376348185
- Entity type
- Individual
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 3138 (MN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-02-17
- Last updated
- 2025-04-14
- Certified
- 2025-04-14
Frequently asked questions
- What is Ethan Jackson's NPI number?
- Ethan Jackson's National Provider Identifier (NPI) is 1376348185, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ethan Jackson's specialty?
- Ethan Jackson is listed in the NPPES registry with a primary specialty of Certified Registered Nurse Anesthetist (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Ethan Jackson located?
- Ethan Jackson's practice location on file with NPPES is 14700 28th Ave N Ste 20, Plymouth, MN 55447-4876.
- What is Ethan Jackson's phone number?
- The practice phone number listed in the NPPES registry for Ethan Jackson is (763) 559-3779.
- Does Ethan Jackson accept Medicare?
- Ethan Jackson is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Ethan Jackson's NPI active?
- Yes — Ethan Jackson's NPI (1376348185) is active in the NPPES registry as of the last update on 2025-04-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.