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

Individual provider Certified Registered Nurse Anesthetist · NPI 1639684699

Johnathan Tyler Nicholls, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Phoenix, Arizona. Qualified in 2016, 10 years ago. Practices with Anesthesia Partners and Management LLC, a 158-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
10
Licensed in
AZ
In the registry since
2017
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

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone: (602) 839-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8424 E Shea Blvd Ste 101, Scottsdale, AZ 85260 — (480) 256-1520

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence CRNA1494 (AZ)

Record details

NPI number1639684699
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorYes
NPI enumeratedDecember 12, 2017
Last updated in NPPESJanuary 30, 2025
Certification dateJanuary 30, 2025

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Anesthesia Partners And Management Llc — 158 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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