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

Mr. Jack Colt Blaine, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1811999642

Mr. Jack Colt Blaine, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Albuquerque, New Mexico. Qualified in 1989, 37 years ago. Practices with Yuma Regional Medical Center, a 372-clinician group and accepts Medicare assignment. Licensed in Arizona, California, New Mexico and Texas.

Years since qualifying
37
Licensed in
AZ, CA, NM, TX
In the registry since
2005
Specialties on file
4
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

See every abbreviation used in this directory →

Practice location Address checks out

6709 Academy Rd NE Ste A
Albuquerque, NM 87109-3363
Phone: (505) 312-4712
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence CRNA00868 (NM)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence CRNA0061 (AZ)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence AP108435 (TX)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence NA1771 (CA)

Record details

NPI number1811999642
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorYes
NPI enumeratedAugust 11, 2005
Last updated in NPPESJanuary 19, 2022
Certification dateJanuary 19, 2022

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 1989 (37 years in practice)
Group practice Yuma Regional Medical Center — 372 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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