Sam Sherrill III, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

902010 Issued in MS

Practice address

202 Old Town LN
Brandon, MS 39042-3658

Phone

(601) 259-3254

NPI assigned

Dec 29, 2025

Last updated

Dec 29, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2025

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)

Hospital & facility affiliations

• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Perioperative Services of Mississippi, LLC

  • Anesthesiology Physician
  • Jackson, MS
  • NPI 1881123123
  Medicare reassignment Care Compare group

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

• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  Care Compare affiliation

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

{
    "created_epoch": "1766966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1275499790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 OLD TOWN LN",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 OLD TOWN LN",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423658",
            "telephone_number": "601-259-3254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERRILL",
        "first_name": "SAM",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-29",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "902010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kholada Shaw
• Michael George Shaw, PMHNP-BC
• Robert Allen Sheely, MD
• Jordan Shelby
• Amy Wallace Sherman, DMD
• Shields of Hope Counseling & Consulting, LLC
• Antwynette Brinkley Shields, DPC, LPC, NCC, CMHT
• Carlie Shields
• Georgia Christine Shirley, CNP
• Brenna Grace W Shoemaker, OT

• Certified Registered Nurse Anesthetist in Brandon, MS
• Providers in Brandon, MS by specialty
• Certified Registered Nurse Anesthetist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; 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.