Individual provider Active NPI

Kevin W Hendry

  • Certified Registered Nurse Anesthetist
  • Ocean Springs, MS
National Provider Identifier
1417148917
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R867218 Issued in MS
Practice address
3109 Bienville Blvd
Ocean Springs, MS 39564-4361
Phone
(228) 809-5000
NPI assigned
Aug 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2007

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 R867218 MS Primary

Addresses

Primary practice location

3109 Bienville Blvd
Ocean Springs, MS 39564-4361

Mailing address

PO Box 789
Ocean Springs, MS 39566-0789
Phone (228) 818-0563

Other identifiers 1

IdentifierTypeStateIssuer
08070835MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101208000919 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204023807 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singing River GulfportGroup PAC ID 5294154829, shared by 3 NPIs, 75 clinicians
Jackson County AnesthesiaGroup PAC ID 9931292729, 37 clinicians
Singing River Health SystemGroup PAC ID 3870405194, shared by 10 NPIs, 290 clinicians

Practice addresses (Care Compare)

15200 Community Rd
Gulfport, MS 39503-3085
Phone (228) 575-7000

2406 Catalpa Ave
Pascagoula, MS 39567-1813
Phone (228) 696-0818

2809 Denny Ave
Pascagoula, MS 39581-5301

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51349TXMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Health System CurrentSince Jul 3, 2017 Accepting new patients
Hogan Surgical Center, P. a. - Crna Services Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2020 Accepting new patients
Singing River Health System CurrentSince Oct 1, 2022 Accepting new patients
Singing River Gulfport CurrentSince Jan 1, 2023 Accepting new patients
Singing River Gulfport CurrentSince Aug 10, 2021 Accepting new patients
Champion Anesthesia Consultants, PLLC CurrentSince Sep 12, 2024 Accepting new patients
Hogan Surgical Center PA CurrentSince Jan 1, 2020 Accepting new patients
Jackson County Anesthesia CurrentSince Jul 26, 2017 Accepting new patients

Locations

2101 Highway 90
Gautier, MS 39553
Phone (228) 497-7576

350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054

351 Cowan Rd
Gulfport, MS 39507
Phone (228) 896-1120

15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000

3109 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 818-1100

2406 Catalpa Ave
Pascagoula, MS 39567
Phone (228) 202-1006

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

Organizations & group practices 8

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186531200000",
    "number": "1417148917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 789",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395660789",
            "telephone_number": "228-818-0563",
            "fax_number": "228-818-0519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 BIENVILLE BLVD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395644361",
            "telephone_number": "228-809-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRY",
        "first_name": "KEVIN",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R867218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08070835",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean Springs, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; 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.