Jed Dean Zak, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R867178 Issued in MS

Practice address

801 Goodyear Blvd
Picayune, MS 39466-3221

Phone

(601) 798-4711

NPI assigned

Feb 26, 2007

Last updated

Jan 15, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Deep South Anesthesia, IncGroup PAC ID 4284897612, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Deep South Anesthesia, Inc

  • Certified Registered Nurse Anesthetist
  • Picayune, MS
  • NPI 1164738712

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Forrest County General Hospital

  • Psychiatric Hospital Unit
  • Hattiesburg, MS
  • NPI 1295837631
  Medicare reassignment NPD
• Forrest County General Hospital

  dba Highland Center for Women's Health RHC

  • Rural Health Clinic/Center
  • Picayune, MS
  • NPI 1043820426
  NPD
• Forrest County General Hospital

  dba Jefferson Davis Rural Health Clinic

  • Rural Health Clinic/Center
  • Prentiss, MS
  • NPI 1689952707
  NPD
• Commonwealth Anesthesia Associates, P.C.

  • Anesthesiology Physician
  • Richmond, VA
  • NPI 1548275308
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1053447037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 N HILL DR W",
            "city": "CARRIERE",
            "state": "MS",
            "postal_code": "394268147",
            "telephone_number": "601-749-5976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 GOODYEAR BLVD",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394663221",
            "telephone_number": "601-798-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAK",
        "first_name": "JED",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R867178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "336508YYGZ",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01689315",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Willow Bend Emergency Group, LLC
• Allison Makayla Wilson
• Natasha Wilson, HAIR LOSS SPECIALIST
• Virginia Wilson, LPC
• Jeanie Woolledge, PHD

• Certified Registered Nurse Anesthetist in Picayune, MS
• Providers in Picayune, MS by specialty
• Certified Registered Nurse Anesthetist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.