Individual provider Active NPI

John S Daly, M.D.

  • Anesthesiology Physician
  • Jackson, MS
National Provider Identifier
1447316732
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
13258 Issued in MS
Practice address
971 Lakeland Dr
Suite 202
Jackson, MS 39216-4643
Phone
(601) 362-1990
Fax
(601) 362-1988
NPI assigned
Dec 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 13258 MS Primary

Addresses

Primary practice location

971 Lakeland Dr
Suite 202
Jackson, MS 39216-4643

Mailing address

971 Lakeland Dr
Suite 202
Jackson, MS 39216-4643
Phone (601) 362-1990

Other identifiers 1

IdentifierTypeStateIssuer
00116647MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070313000503 MS Practitioner - Anesthesiology 8921101866 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Mississippi School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Anesthesia Group Staffing, LLCGroup PAC ID 2769928795, 21 clinicians
Physicians Anesthesia Group, P.a.Group PAC ID 6103806864, 54 clinicians

Practice addresses (Care Compare)

1190 N State St
Jackson, MS 39202-2413
Phone (601) 968-1790

971 Lakeland Dr
Jackson, MS 39216-4643
Phone (601) 200-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13258MSMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Anesthesia Group, P.a. Anesthesiology CurrentSince Dec 18, 2006 Accepting new patients
Physicians Anesthesia Group Staffing, LLC Anesthesiology CurrentSince Jun 17, 2024 Accepting new patients
Jackson Anesthesia Associates PA Anesthesiology CurrentSince Sep 1, 2022 Accepting new patients

Locations

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

1053 River Oaks Dr
Flowood, MS 39232
Phone (601) 969-1430

1053 River Oaks Dr
#C
Flowood, MS 39232
Phone (601) 969-1430

1190 N State St
Ste 102
Jackson, MS 39202
Phone (601) 968-1790

501 Marshall St
Ste 301
Jackson, MS 39202

971 Lakeland Dr
Jackson, MS 39216
Phone (601) 939-5922

971 Lakeland Dr
Ste 202
Jackson, MS 39216
Phone (601) 362-1990

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447316732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 202",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-362-1990",
            "fax_number": "601-362-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 202",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-362-1990",
            "fax_number": "601-362-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALY",
        "first_name": "JOHN",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "13258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00116647",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.