Jerry L Mixon, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

227393 Issued in TX

Practice address

4920 NE Stallings Dr
Nacogdoches, TX 75965-1254

Phone

(936) 569-9481

Fax

(936) 462-4333

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• The Center for Sight, PA

  • Ophthalmology Physician
  • Lufkin, TX
  • NPI 1053494245
  NPD

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235952000000",
    "number": "1306945944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632114",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759632114",
            "telephone_number": "936-568-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 NE STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651254",
            "telephone_number": "936-569-9481",
            "fax_number": "936-462-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIXON",
        "first_name": "JERRY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2009-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "227393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "088527903",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "88693U",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Milstead & Associates Counseling Group
• Brittany Brown Milstead, LPC
• Mindful Nutrition Counseling LLC
• Mindful Nutrition Counseling LLC
• Max Hamilton Mitchell, PT
• Michelle Mixon
• Mobility Scooters
• Binusha Moitheennazima, MD
• Michael Edward Mollot, M.D.
• Amber Jolene Monk, LVN

• Certified Registered Nurse Anesthetist in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; 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.