Individual provider Active NPI

Joshua Kendrick Ezelle, DNP, CRNA

  • Certified Registered Nurse Anesthetist
  • Hattiesburg, MS
National Provider Identifier
1114469459
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
103647 Issued in WI
Practice address
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone
(601) 261-3606
Fax
(601) 579-5383
NPI assigned
Nov 16, 2016
Last updated
Apr 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 901423 MS
Certified Registered Nurse Anesthetist 367500000X 103647 WI Primary

Addresses

Primary practice location

415 S 28TH Ave
Hattiesburg, MS 39401-7246

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 261-3606

Other practice location 1

9576 Hwy 70
Minocqua, WI 54548-9067
Phone (715) 358-1000

Other identifiers 1

IdentifierTypeStateIssuer
03236349MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jezelle59011@directpatientrecord.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170210000520 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658654991 Reassigns benefits to 2 organizations
I20260113002426 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658654991 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCHS Hospitals IncGroup PAC ID 5698071173, 1,195 clinicians
Lifelinc Anesthesia PLLCGroup PAC ID 0941347447, 169 clinicians
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

3688 Veterans Memorial Dr
Suite 100
Hattiesburg, MS 39401-8246
Phone (601) 554-7525

415 S 28TH Ave
Hattiesburg Clinic Department of Neurosurge
Hattiesburg, MS 39401-7246
Phone (601) 579-5459

9576 Hwy 70
Minocqua, WI 54548-9067
Phone (715) 358-1710

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
901423MSMDCertified Registered Nurse Anesthetist
103647WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Dec 7, 2025 Accepting new patients
Flambeau Hospital Inc CurrentSince Dec 7, 2025 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Dec 7, 2025 Accepting new patients
Memorial Hospital Inc CurrentSince Dec 7, 2025 Accepting new patients
MCHS Hospitals Inc CurrentSince Dec 7, 2025 Accepting new patients
MCHS Hospitals Inc CurrentSince Dec 7, 2025 Accepting new patients
Flambeau Hospital Inc CurrentSince Dec 7, 2025 Accepting new patients
Hattiesburg Clinic PA CurrentSince Jan 31, 2017 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Dec 7, 2025 Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 4, 2025 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Jan 31, 2017 Accepting new patients
Marshfield Clinic Inc CurrentSince Dec 7, 2025 Accepting new patients
MCHS Hospitals Inc CurrentSince Dec 7, 2025 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Dec 7, 2025 Accepting new patients
Memorial Hospital Inc Past Accepting new patients
Flambeau Hospital Inc Past Accepting new patients
Beaver Dam Community Hospitals Inc Past Accepting new patients

Locations

634 Leigh Dr
Columbus, MS 39705
Phone (601) 978-3393

3688 Veterans Memorial Dr
Ste 100
Hattiesburg, MS 39401
Phone (601) 554-7525

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

707 S University Ave
Beaver Dam, WI 53916
Phone (920) 887-4006

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1200 Port Arthur Rd
Ladysmith, WI 54848
Phone (715) 532-2300

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

9576 State Highway 70
Minocqua, WI 54548
Phone (715) 358-1000

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

98 Sherry Ave
Park Falls, WI 54552
Phone (715) 762-2484

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 3

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": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1114469459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-261-3606",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-261-3606",
            "fax_number": "601-579-5383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9576 Hwy 70",
            "address_purpose": "LOCATION",
            "city": "Minocqua",
            "state": "WI",
            "postal_code": "545489067",
            "country_code": "US",
            "telephone_number": "715-358-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EZELLE",
        "first_name": "JOSHUA",
        "middle_name": "KENDRICK",
        "credential": "DNP, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-16",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "901423",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "103647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03236349",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jezelle59011@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "415 S 28th Ave",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394017246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; 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.