Active NPI
Thomas M Walters, CRNA
- Certified Registered Nurse Anesthetist
- Hattiesburg, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R717886
- Practice address
- 415 S 28TH Ave
Hattiesburg, MS 39401-7246 - Phone
- (601) 261-3606
- Fax
- (601) 579-5166
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R717886 | MS | Primary |
Addresses
Primary practice location
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Mailing address
15 Avery KNLS
Hattiesburg, MS 39402-8131
Phone (601) 297-6283
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1501859 | Medicaid | LA | |
| 00114837 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS, AL, FL
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
123 Baptist Way
Pensacola, FL 32503-2254
Phone (448) 227-8478
415 S 28TH Ave
Hattiesburg, MS 39401-7246
415 S 28TH Ave 3Rd Floor
Ambulatory Cardiovascular Center of Mississ
Hattiesburg, MS 39401-7246
Phone (601) 268-1734
415 S 28TH Ave FL
Hattiesburg, MS 39401-7246
Phone (601) 264-6000
6051 U S Hwy 49
Forrest General Hospital
Hattiesburg, MS 39401-7200
Phone (601) 264-6000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Perioperative Services of Mississippi, LLC | Current | Accepting new patients | |
| Hattiesburg Clinic PA | Current | Accepting new patients | |
| Ams of Gulf Breeze LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| USA Health Anesthesia Billing Services, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Hattiesburg Clinic, PA | Current | Accepting new patients | |
| Ams Baptist LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Lifelinc Anesthesia, PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
1700 Center St
Mobile, AL 36604
Phone (251) 415-1000
2451 Fillingim St
Mobile, AL 36617
Phone (251) 434-3711
123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011
1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848
350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500
634 Leigh Dr
Columbus, MS 39705
Phone (601) 978-3393
415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606
1225 N State St
Jackson, MS 39202
Phone (601) 292-4261
1710 W 12th St
Laurel, MS 39440
Phone (601) 369-2021
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Hattiesburg, MS
- NPI 1740213446
-
- Anesthesiology Physician
- Pensacola, FL
- NPI 1093020216
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Jackson, MS
- NPI 1881123123
-
- Anesthesiology Physician
- Pensacola, FL
- NPI 1376812032
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Memphis, TN
- NPI 1801021464
MS, Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Mobile, AL
- NPI 1629635818
Nurse Anesthetist, Certified Registered
-
dba Flowood Primary Care
- Primary Care Clinic/Center
- Flowood, MS
- NPI 1912600354
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hattiesburg, MS
- NPI 1225041809
-
- General Acute Care Hospital
- Pensacola, FL
- NPI 1700979465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706140800000",
"number": "1336160050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 AVERY KNLS",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394028131",
"telephone_number": "601-297-6283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 S 28TH AVE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017246",
"telephone_number": "601-261-3606",
"fax_number": "601-579-5166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "THOMAS",
"middle_name": "M",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2024-01-25",
"certification_date": "2024-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MS",
"license": "R717886",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1501859",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00114837",
"state": "MS"
}
],
"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 Jan 25, 2024; 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.