Individual provider Active NPI

William Brent Miley, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, MS
National Provider Identifier
1154961340
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
882885 Issued in MS
Practice address
1850 Chadwick Drive
Jackson, MS 39204
Phone
(334) 279-1450
Fax
(334) 279-1660
NPI assigned
Jan 15, 2020
Last updated
Jan 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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 882885 MS Primary

Addresses

Primary practice location

1850 Chadwick Drive
Jackson, MS 39204

Mailing address

P.O. Box 235019
Montgomery, AL 36123
Phone (334) 279-1450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200324000100 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012345150 Reassigns benefits to 1 organization
I20200427000621 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012345150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perioperative Services of Mississippi, LLCGroup PAC ID 8921365255, 98 clinicians

Practice addresses (Care Compare)

1225 N State St
Ms Baptist Medical Center
Jackson, MS 39202-2064
Phone (601) 317-2802

350 Crossgates Blvd
Brandon, MS 39042-2601
Phone (604) 317-2802

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
901619MSMDAcute Care Nurse Practitioner
882885MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiologists Associated PC CurrentSince Mar 21, 2020 Accepting new patients
Anesthesiologists Associated PC Nurse Anesthetist, Certified Registered CurrentSince Mar 21, 2020 Accepting new patients
Perioperative Services of Mississippi, LLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

701 Princeton Ave SW
Birmingham, AL 35211
Phone (205) 279-2860

5 Mobile Infirmary Cir
Mobile, AL 36607
Phone (251) 432-4415

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

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

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1154961340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 235019",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36123",
            "telephone_number": "334-279-1450",
            "fax_number": "334-279-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 CHADWICK DRIVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39204",
            "telephone_number": "334-279-1450",
            "fax_number": "334-279-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILEY",
        "first_name": "WILLIAM",
        "middle_name": "BRENT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "882885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

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