NPIMap

Individual provider Active NPI

Jonathan Blake Benefield, CRNA

  • Certified Registered Nurse Anesthetist
  • Gulfport, MS
National Provider Identifier
1215217013
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R874062 Issued in MS
Practice address
4500 13TH St
Gulfport, MS 39501-2515
Phone
(228) 867-4000
Fax
(228) 867-5117
NPI assigned
Aug 24, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

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 R874062 MS Primary

Addresses

Primary practice location

4500 13TH St
Gulfport, MS 39501-2515

Mailing address

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111019000331 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345412219 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Louisiana State University School of Medicine in New Orleans, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Best Anesthesia PLLCGroup PAC ID 9436521168, 20 clinicians
Etas PLLCGroup PAC ID 8123481934, 43 clinicians

Practice addresses (Care Compare)

150 Reynoir St
Biloxi, MS 39530-4130
Phone (228) 284-2389

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-4000

Hospital & facility affiliations

  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R874062MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport CurrentSince Mar 15, 2014 Accepting new patients
Magnolia State Anesthesia Services, PLLC CurrentSince Dec 7, 2023 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Best Anesthesia, PLLC CurrentSince May 4, 2025 Accepting new patients
Etas, PLLC CurrentSince Aug 1, 2023 Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 16, 2019 Accepting new patients
Gulf Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 17, 2013 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Mar 15, 2014 Accepting new patients

Locations

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

150 Reynoir St
Biloxi, MS 39530
Phone (228) 432-7817

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

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000

14225 Dedeaux Rd
Gulfport, MS 39503
Phone (228) 328-0972

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

2406 Catalpa Ave
Pascagoula, MS 39567
Phone (228) 202-1006

Organizations & group practices 9

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 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1215217013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-867-4000",
            "fax_number": "228-867-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-867-4000",
            "fax_number": "228-867-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEFIELD",
        "first_name": "JONATHAN",
        "middle_name": "BLAKE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-24",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R874062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; 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.