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SOUTHCREST ANESTHESIA SERVICES PLLC NPI 1942302617


NPI Information

NPI: 1942302617
Provider Name: SOUTHCREST ANESTHESIA SERVICES, PLLC
Classification: Nurse Anesthetist, Certified Registered - 367500000X
Entity Type: Organization
Address:
7580 CLARINGTON CV
SOUTHAVEN, MS
ZIP 38671
Phone: (662) 349-9136
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SOUTHCREST ANESTHESIA SERVICES, PLLC is a nurse anesthetist certified registered in Southaven, MS. 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. SOUTHCREST ANESTHESIA SERVICES, PLLC NPI is 1942302617. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7580 CLARINGTON CV
SOUTHAVEN, MS
ZIP 38671-657
Phone: (662) 349-9136
Fax: (662) 349-0677

The provider's authorized official is Robert Lawrence Ryan .
The authorized official title is Owner Practice Manager and has the following contact phone number (662) 349-9136.

The enumeration date for this NPI number is 9/2/2006 and was last updated on 4/20/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1367500000XNurse Anesthetist, Certified RegisteredR691259MISSISSIPPIYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1C03305MEDICARE ID-TYPE UNSPECIFIEDMISSISSIPPI
2=========OTHERMISSISSIPPIBC/BS MISSISSIPPI
309015237MEDICAIDMISSISSIPPI

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: 4/28/2024

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