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MISSISSIPPI ANESTHESIA GROUP LLC NPI 1366845554


NPI Information

NPI: 1366845554
Provider Name: MISSISSIPPI ANESTHESIA GROUP, LLC
Classification: Nurse Anesthetist, Certified Registered - 367500000X
Entity Type: Organization

CLIA Number: 25D2177508

Address:
145 SANCTUARY LN
CANTON, MS
ZIP 39046
Phone: (601) 855-7440
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MISSISSIPPI ANESTHESIA GROUP, LLC is a nurse anesthetist certified registered in Canton, 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. MISSISSIPPI ANESTHESIA GROUP, LLC NPI is 1366845554. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

145 SANCTUARY LN
CANTON, MS
ZIP 39046-601
Phone: (601) 855-7440

The provider's authorized official is Gary Dwayne Self .
The authorized official title is Founder And President and has the following contact phone number (601) 668-5628.

The CLIA number assigned to this NPI record is 25D2177508 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/1/2014 and was last updated on 10/1/2014.


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 RegisteredR598755MISSISSIPPIYes

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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