Individual provider Active NPI

Jeffrey J Michel, CRNA

  • Certified Registered Nurse Anesthetist
  • Brookhaven, MS
National Provider Identifier
1023069333
Registry record updated Nov 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
862871 Issued in MS
Practice address
427 Highway 51 N
Brookhaven, MS 39601-2350
Phone
(660) 826-5960
Fax
(660) 826-4852
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 14

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

Hospital & facility affiliations 2

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

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
McComb Anesthesia Associates, LLP 16 clinicians
Kings Daughters Medical Center 75 clinicians

Practice addresses (Care Compare)

215 Marion Ave
McComb, MS 39648-2705
Phone (601) 249-5500

427 Hwy 51 N
Brookhaven, MS 39601-2350
Phone (601) 833-6011

Hospital & facility affiliations

  • King'S Daughters Medical Center-Brookhaven Hospital, Brookhaven, MS, CCN 250057
  • Southwest Ms Regional Medical Center Hospital, McComb, MS, CCN 250097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TX2 enrollments

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20050801000719 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 1759319775 Reassigns benefits to 4 organizations
I20231113000278 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 1759319775 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1074860ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Perioperative Services of Mississippi, LLC CurrentSince Dec 8, 2022 Accepting new patients
Kings Daughters Medical Center Nurse Anesthetist, Certified Registered CurrentSince Mar 20, 2010 Accepting new patients
Christus Health Ark-la-Tex CurrentSince Nov 8, 2023 Accepting new patients
McComb Anesthesia Associates, LLP Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients
Christus Health Ark-la-Tex Current Accepting new patients
King'S Daughters Medical Center CurrentSince Mar 20, 2010 Accepting new patients
Physicians Anesthesia Group, P.a. CurrentSince Jul 15, 2021 Accepting new patients
Christus Health Ark-la-Tex CurrentSince Nov 8, 2023 Accepting new patients
Natchez Regional Medical Center Past Accepting new patients
Vaughan Regional Medical Center LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500

427 Highway 51 N
Brookhaven, MS 39601
Phone (601) 833-6011

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

971 Lakeland Dr
Jackson, MS 39216
Phone (601) 939-5922

215 Marion Ave
McComb, MS 39648
Phone (601) 249-1180

2604 Saint Michael Dr
Ste 239
Texarkana, TX 75503
Phone (903) 614-5330

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 862871 MS Primary

Addresses

NPPES NPI Registry

Primary practice location

427 Highway 51 N
Brookhaven, MS 39601-2350

Mailing address

PO Box 1547
Sedalia, MO 65302-1547
Phone (660) 826-5960

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
00124980MedicaidMS

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 9, 2017.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1023069333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1547",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653021547",
            "telephone_number": "660-826-5960",
            "fax_number": "660-826-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 HIGHWAY 51 N",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012350",
            "telephone_number": "660-826-5960",
            "fax_number": "660-826-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHEL",
        "first_name": "JEFFREY",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "862871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124980",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; 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.