NPIMap

Individual provider Active NPI

Robert Harris, CRNA

  • Certified Registered Nurse Anesthetist
  • Biloxi, MS
National Provider Identifier
1487719738
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R805018 Issued in MS
Practice address
150 Reynoir St
Biloxi, MS 39530-4130
Phone
(228) 385-1451
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 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 R805018 MS Primary

Addresses

Primary practice location

150 Reynoir St
Biloxi, MS 39530-4130

Mailing address

147 Reynoir St
Suite 203
Biloxi, MS 39530-4109

Other identifiers 1

IdentifierTypeStateIssuer
00124377MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070509000634 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012013980 Reassigns benefits to 6 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
Etas PLLCGroup PAC ID 8123481934, 43 clinicians

Practice addresses (Care Compare)

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R805018MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport CurrentSince Sep 1, 2016 Accepting new patients
Singing River Gulfport CurrentSince Jan 1, 2023 Accepting new patients
Best Anesthesia, PLLC CurrentSince Jan 1, 2023 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2021 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 5, 2023 Accepting new patients
Singing River Gulfport CurrentSince Jan 1, 2023 Accepting new patients
Etas, PLLC CurrentSince Sep 1, 2023 Accepting new patients
Gulfport Anesthesia Services, P.a. Past Accepting new patients
Gulfport Outpatient Anesthesia, P.a. Past Accepting new patients

Locations

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

150 Reynoir St
Biloxi, MS 39530
Phone (228) 432-7817

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

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

4500 13th St
Fl 2
Gulfport, MS 39501
Phone (228) 865-3281

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

15190 Community Rd
Ste 230A
Gulfport, MS 39503
Phone (228) 831-0204

1926 23rd Ave
Meridian, MS 39301
Phone (601) 485-1131

3882 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 872-6290

Organizations & group practices 11

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 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1487719738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 REYNOIR ST",
            "address_2": "SUITE 203",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395304109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 REYNOIR ST",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395304130",
            "telephone_number": "228-385-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ROBERT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R805018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124377",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.