Individual provider Active NPI

Lacey W Whittington, CRNA

  • Certified Registered Nurse Anesthetist
  • Flowood, MS
National Provider Identifier
1164832408
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R882956 Issued in MS
Practice address
1026 N Flowood Dr
Flowood, MS 39232-9532
Phone
(601) 932-1000
NPI assigned
May 7, 2014
Last updated
May 7, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2014

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 R882956 MS Primary

Addresses

Primary practice location

1026 N Flowood Dr
Flowood, MS 39232-9532

Mailing address

3010 Lakeland CV
Suite J
Flowood, MS 39232-9784
Phone (601) 936-0684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151022000692 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446569057 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R882956MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Foundation of Central Ms CurrentSince Aug 15, 2015 Accepting new patients
Baptist Nutrition Clinic CurrentSince Aug 15, 2015 Accepting new patients
Anesthesia Consultants PA Nurse Anesthetist, Certified Registered CurrentSince Aug 12, 2015 Accepting new patients
Medical Foundation of Central Mississippi, Inc. Current Accepting new patients
Jackson Anesthesia Associates PA CurrentSince May 1, 2017 Accepting new patients
Perioperative Services of Mississippi, LLC CurrentSince Feb 23, 2023 Accepting new patients
Lakeland Anesthesia, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

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

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

1030 River Oaks Dr
Jackson, MS 39232
Phone (601) 376-2165

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

1026 N Flowood Dr
Jackson, MS 39232
Phone (601) 932-1000

401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383

Organizations & group practices 7

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": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1164832408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 LAKELAND CV",
            "address_2": "SUITE J",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329784",
            "telephone_number": "601-936-0684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 N FLOWOOD DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329532",
            "telephone_number": "601-932-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTINGTON",
        "first_name": "LACEY",
        "middle_name": "W",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-07",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R882956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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.