Audrey Donna Ghatas, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Magee, MS
NPI 1508960295 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1508960295
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- R125620 (MS)
- Practice address
- 300 3Rd Ave SE
Magee, MS 39111-3665 - Phone
- (601) 849-7173
- Fax
- (601) 849-7353
- NPI assigned
- Sep 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 13
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- South Central Clinics, Inc
Lifelinc Anesthesia PLLC
Practice addresses (Care Compare)
1002 Jefferson St
Laurel, MS 39440-4306
1100 Belk Blvd
Oxford, MS 38655-5242
Phone (662) 232-8100
1203 Ave B
Ellisville, MS 39437-2080
Phone (601) 477-2226
1220 Jefferson St
Laurel, MS 39440-4355
Phone (601) 399-6169
5001 Hardy St
Hattiesburg, MS 39402-1308
Phone (601) 268-8000
Hospital & facility affiliations
- South Central Reg Med Ctr
- Merit Health Wesley
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111229000024 | MS | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 0648446468 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R125620 | MS | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Youngs Professional Services LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Southern Anesthesia Inc | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Magee Benevoent Association | Current |
Accepting new patients | |
| Lifelinc Anesthesia, PLLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Magee Benevolent Association | Current |
Accepting new patients | |
| South Central Clinics, Inc | Current |
Accepting new patients | |
| Magee Benevolent Association | Current | Accepting new patients | |
| South Central Clinics, Inc | Current | Accepting new patients | |
| South Central Cinics, Inc | Current |
Accepting new patients |
Locations
634 Leigh Dr
Columbus, MS 39705
Phone (601) 978-3393
1203 B Ave
Ellisville, MS 39437
Phone (601) 477-8553
139 Fairfield Dr
Hattiesburg, MS 39402
Phone (601) 450-2401
5001 Hardy St
Hattiesburg, MS 39402
Phone (601) 268-8000
1220 Jefferson St
Laurel, MS 39440
Phone (601) 426-4000
1710 W 12th St
Laurel, MS 39440
Phone (601) 369-2021
300 SE 3rd Ave
Magee, MS 39111
Phone (601) 849-5070
1926 23rd Ave
Meridian, MS 39301
Phone (601) 485-1131
499 Azalea Dr
Oxford, MS 38655
Phone (662) 234-7979
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R125620 | MS | Yes |
Addresses
Primary practice location
300 3Rd Ave SE
Magee, MS 39111-3665
Mailing address
PO Box 669
Mount Olive, MS 39119-0669
Phone (601) 466-3601
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00110086 | Medicaid | MS |
Other providers in Magee, MS
- Kelli S Fewell
- Freds Stores of Tennessee Inc
- James Ladd Garner
- Jessica April Garner
- Gene Polks Inc
- Jonathan Adam Giangrosso
- Gilbert'S Hospice Care of Mississippi, LLC
- Jonathan W. Glenn
- GPRX LLC
- Maggie Griffith
All providers in Magee, MS · Certified Registered Nurse Anesthetist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.