Individual provider Active NPI

Christopher Sumrall

  • Certified Registered Nurse Anesthetist
  • Vicksburg, MS
National Provider Identifier
1124409339
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R876323 Issued in MS
Practice address
2100 Highway 61 N
Vicksburg, MS 39183-8211
Phone
(601) 218-6136
NPI assigned
Jun 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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 R876323 MS Primary

Addresses

Primary practice location

2100 Highway 61 N
Vicksburg, MS 39183-8211

Mailing address

135 Marion Dr.
Clinton, MS 39056

Other practice location 1

415 S 28th Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150721001987 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810200789 Reassigns benefits to 5 organizations
I20231201002451 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810200789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

Hospital & facility affiliations

  • Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 18, 2023 Accepting new patients
Jackson Anesthesia Associates PA CurrentSince May 1, 2019 Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2019 Accepting new patients
Capital Anesthesia Solutions of Arkansas, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 17, 2024 Accepting new patients
Hattiesburg Clinic PA CurrentSince Aug 9, 2023 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Aug 9, 2023 Accepting new patients
Perioperative Services of Mississippi, LLC CurrentSince Apr 1, 2018 Accepting new patients
Northstar Anesthesia of Mississippi, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2015 Accepting new patients

Locations

700 W Grove St
El Dorado, AR 71730
Phone (870) 863-2200

300 Werner St
Hot Springs National Park, AR 71913
Phone (501) 622-1000

603 N Progress Ave
Siloam Springs, AR 72761
Phone (479) 215-3000

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

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

1053 River Oaks Dr
#C
Flowood, MS 39232
Phone (601) 969-1430

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

5001 Hardy St
Hattiesburg, MS 39402
Phone (601) 268-8000

1850 Chadwick Dr
Jackson, MS 39204
Phone (601) 376-1000

499 Azalea Dr
Oxford, MS 38655
Phone (662) 234-7979

2100 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-5001

Organizations & group practices 8

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 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": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1124409339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 MARION DR.",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "39056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838211",
            "telephone_number": "601-218-6136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 S 28th Ave",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394017246",
            "country_code": "US",
            "telephone_number": "601-264-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMRALL",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-12",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R876323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.