NPIMap

Organization Active NPI

Hattiesburg Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Hattiesburg, MS
National Provider Identifier
1265564041
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
HATTIESBURG ANESTHESIA ASSOCIATES, LLC
Practice address
5001 Hardy St
Hattiesburg, MS 39402-1308
Phone
(601) 268-8000
NPI assigned
Mar 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kenneth Raynor Ellington, MDNPI 1144244112
Title
President
Phone
(864) 591-1540

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

5001 Hardy St
Hattiesburg, MS 39402-1308

Mailing address

158 W Main St
Spartanburg, SC 29306-2333
Phone (864) 591-1540

National Provider Directory

National Provider Directory

Locations

158 W Main St
Spartanburg, SC 29306

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265564041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 W MAIN ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293062333",
            "telephone_number": "864-591-1540",
            "fax_number": "864-591-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 HARDY ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021308",
            "telephone_number": "601-268-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HATTIESBURG ANESTHESIA ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLINGTON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "RAYNOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-591-1540",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.