Individual provider Active NPI

Cheryl Ann Marble, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, MS
National Provider Identifier
1336179373
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R844765 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 815-2005
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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 R844765 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

504 Clinton Center Dr Ste 4300
Clinton, MS 39056-5610
Phone (601) 815-2005

Other identifiers 1

IdentifierTypeStateIssuer
02975011OtherMSMS MEDICAID

Other names 1

  • Cheryl Ann Dunaway Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070924000497 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 8820182660 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
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)

1225 N State St
Ms Baptist Medical Center
Jackson, MS 39202-2064
Phone (601) 317-2802

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R844765MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Perioperative Services of Mississippi, LLC CurrentSince Feb 7, 2024 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 1, 2006 Accepting new patients
Copiah County Medical Center CurrentSince Jan 1, 2012 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
Copiah County Medical Center CurrentSince Jan 1, 2012 Accepting new patients
Copiah County Medical Center Current Accepting new patients
State of Mississippi-University of Mississippi Medical Center Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2006 Accepting new patients

Locations

350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

27190 Highway 28
Hazlehurst, MS 39083
Phone (601) 574-7000

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

350 W Woodrow Wilson Ave
Jackson, MS 39213
Phone (601) 364-2666

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

Interoperability endpoints

  • Direct secure messaging: cdunaway7396@ummc.direct-ci.com

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1336179373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 CLINTON CENTER DR STE 4300",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565610",
            "telephone_number": "601-815-2005",
            "fax_number": "601-815-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-815-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARBLE",
        "first_name": "CHERYL",
        "middle_name": "ANN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R844765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS MEDICAID",
            "identifier": "02975011",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "DUNAWAY",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.