Individual provider Active NPI

Chrystal Kelley, CRNA

  • Certified Registered Nurse Anesthetist
  • Oxford, MS
National Provider Identifier
1366535874
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R863288 Issued in MS
Practice address
2301 South Lamar Blvd.
Oxford, MS 38655-6002
Phone
(662) 232-8100
Fax
(334) 244-1830
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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 R863288 MS Primary

Addresses

Primary practice location

2301 South Lamar Blvd.
Oxford, MS 38655-6002

Mailing address

P.O. Box 235022
Montgomery, AL 36123-5022
Phone (334) 386-2053

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070307000222 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284737511 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelinc Anesthesia PLLCGroup PAC ID 0941347447, 169 clinicians
Tupelo Anesthesia Group, PAGroup PAC ID 4587566344, 32 clinicians

Practice addresses (Care Compare)

634 Leigh Dr
Columbus, MS 39705-3014
Phone (866) 362-6963

723 Concordia Ave
Suite 201
Oxford, MS 38655-1991
Phone (662) 377-4394

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Hospital North Mississippi, Inc CurrentSince Jan 4, 2006 Accepting new patients
Baptist Memorial Hospital North Mississippi, Inc CurrentSince Jan 4, 2006 Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 12, 2016 Accepting new patients
Willow Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 24, 2014 Accepting new patients

Locations

634 Leigh Dr
Columbus, MS 39705
Phone (601) 978-3393

960 Avent Dr
Grenada, MS 38901
Phone (662) 227-7000

1100 Belk Blvd
Oxford, MS 38655
Phone (662) 636-1000

2704 West Oxford Loop
Ste 117
Oxford, MS 38655
Phone (662) 550-4299

2301 S Lamar Blvd
Oxford, MS 38655
Phone (662) 232-8369

499 Azalea Dr
Oxford, MS 38655
Phone (662) 234-7979

7600 Airways Blvd
Ste D
Southaven, MS 38671
Phone (662) 349-7477

Interoperability endpoints

  • Direct secure messaging: ckelley15537@direct.bmhcc.org

Organizations & group practices 6

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1366535874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 235022",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235022",
            "telephone_number": "334-386-2053",
            "fax_number": "334-244-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 SOUTH LAMAR BLVD.",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386556002",
            "telephone_number": "662-232-8100",
            "fax_number": "334-244-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "CHRYSTAL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R863288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.