Zachary Halliwell, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

899108 Issued in MS

Practice address

969 Lakeland Dr
Jackson, MS 39216-4606

Phone

(601) 200-2000

NPI assigned

Jan 7, 2020

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

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kings Daughters Medical CenterGroup PAC ID 3072575539, 75 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• King's Daughters Medical Center-Brookhaven Hospital, Brookhaven, MS, CCN 250057

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Kings Daughters Medical Center

  dba Kings Daughters Pro Anesthesia

  • Anesthesiology Physician
  • Brookhaven, MS
  • NPI 1043245368

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Physicians Anesthesia Group, P.a.

  • Anesthesiology Physician
  • Jackson, MS
  • NPI 1407890783
  Medicare reassignment NPD
• King's Daughters Medical Center

  dba King's Daughters Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • Brookhaven, MS
  • NPI 1881476364
  NPD

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

• King's Daughters Medical Center

  • General Acute Care Hospital
  • Brookhaven, MS
  • NPI 1972503464
  Care Compare affiliation

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1053951194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235019",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164606",
            "telephone_number": "601-200-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLIWELL",
        "first_name": "ZACHARY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "899108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rian Danielle Hall, APRN
• Ruby S Hall
• Samuel Claude Hall, DO
• Talyr Hall, MD
• William Hall, MS
• Maury W Hallman, CRNA
• Craig Kenneth Hallstrom, M.D.
• Joseph Bryant Halsch
• James R Haltom, MD
• David Elder Hamby, N.P

• Certified Registered Nurse Anesthetist in Jackson, MS
• Providers in Jackson, 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 7, 2020; 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.