Individual provider Active NPI

Bradley W Jones, CRNA

  • Certified Registered Nurse Anesthetist
  • Tupelo, MS
National Provider Identifier
1013939370
Registry record updated Nov 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R798017 Issued in MS
Practice address
830 S Gloster St
Tupelo, MS 38801-4934
Phone
(662) 377-4394
Fax
(662) 377-7045
NPI assigned
Jul 24, 2006
Last updated
Nov 19, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R798017 MS Primary

Addresses

Primary practice location

830 S Gloster St
Tupelo, MS 38801-4934

Mailing address

PO Box 3294
Tupelo, MS 38803-3294
Phone (662) 377-4394

Other identifiers 1

IdentifierTypeStateIssuer
00123799MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050104000060 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608824990 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4566 S Eason Blvd
Tupelo, MS 38801-6540

830 S Gloster
North Ms Med Ctr Sleep Lab
Tupelo, MS 38801-4934
Phone (662) 377-3258

830 S Gloster St
Tupelo, MS 38801-4934

830 S Gloster St 3Rd FL E Tower
Tupelo, MS 38801-4934

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R798017MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Trident Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2014 Accepting new patients
DHS Anesthesia, LLC CurrentSince Sep 1, 2017 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Monroe Health Services, Inc. CurrentSince Mar 13, 2021 Accepting new patients
Tupelo Anesthesia Group PA CurrentSince Feb 7, 2011 Accepting new patients
Monroe Health Services, Inc. CurrentSince Mar 13, 2021 Accepting new patients
North Mississippi Medical Center CurrentSince Sep 27, 2004 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Sep 27, 2004 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
South Texas Radiology Imaging Centers Past Accepting new patients
South Texas Radiology Group PA Past Accepting new patients
Corinth Surgery Center, LLC Past Accepting new patients

Locations

1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111

110 Walker Way
Starkville, MS 39759
Phone (662) 320-6555

2089 Southridge Dr
Tupelo, MS 38801
Phone (662) 407-0801

589 Garfield St
Tupelo, MS 38801
Phone (601) 680-5565

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: bradleyjones@nmhs.medalliesdirect.net

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290124800000",
    "number": "1013939370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3294",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388033294",
            "telephone_number": "662-377-4394",
            "fax_number": "662-377-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014934",
            "telephone_number": "662-377-4394",
            "fax_number": "662-377-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "BRADLEY",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2010-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R798017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00123799",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.