Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jared Lyle Watkins, CRNA

Individual provider Registered Nurse · NPI 1578196119

Jared Lyle Watkins, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Raleigh, North Carolina. Qualified in 2022, 4 years ago. Practices with Medical Park Hospital LLC, a 109-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
4
Licensed in
NC
In the registry since
2020
Specialties on file
3
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

4420 Lake Boone Trl
Raleigh, NC 27607-7505
Phone: (404) 502-8878
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 6982 (NC)
Registered Nurse Taxonomy 163W00000X · Licence 288449 (NC)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1578196119
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorYes
NPI enumeratedFebruary 21, 2020
Last updated in NPPESOctober 12, 2022
Certification dateOctober 12, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Medical Park Hospital Llc — 109 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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