Active NPI
Carolyn Chay Costilow
- Certified Registered Nurse Anesthetist
- Oxford, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 141317
- Practice address
- 1100 Belk Blvd
Oxford, MS 38655-5242 - Phone
- (662) 636-1000
- NPI assigned
- Aug 24, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 141317 | MS | Primary |
Addresses
Primary practice location
1100 Belk Blvd
Oxford, MS 38655-5242
Mailing address
124 Breckenridge Dr
Oxford, MS 38655-7502
Other practice location 1
315 Hospital Dr
Madison, TN 37115-5030
Phone (615) 732-7671
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2100 Exeter Rd
Suite 200
Germantown, TN 38138-3966
Phone (901) 699-4436
960 Avent Dr
Grenada, MS 38901-5230
Phone (662) 227-7000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 141317 | MS | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willow Anesthesia Services LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Lifelinc Anesthesia, PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
634 Leigh Dr
Columbus, MS 39705
Phone (601) 978-3393
960 Avent Dr
Grenada, MS 38901
Phone (662) 227-7000
499 Azalea Dr
Oxford, MS 38655
Phone (662) 234-7979
1100 Belk Blvd
Oxford, MS 38655
Phone (662) 636-1000
Organizations & group practices 2
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.
-
- Certified Registered Nurse Anesthetist
- Oxford, MS
- NPI 1205169521
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Memphis, TN
- NPI 1801021464
MS, Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital
- Grenada, MS
- NPI 1083041917
-
- General Acute Care Hospital
- Grenada, MS
- NPI 1558798603
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678752000000",
"number": "1538836846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 BRECKENRIDGE DR",
"city": "OXFORD",
"state": "MS",
"postal_code": "386557502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 BELK BLVD",
"city": "OXFORD",
"state": "MS",
"postal_code": "386555242",
"telephone_number": "662-636-1000"
}
],
"practiceLocations": [
{
"address_1": "315 Hospital Dr",
"address_purpose": "LOCATION",
"city": "Madison",
"state": "TN",
"postal_code": "371155030",
"country_code": "US",
"telephone_number": "615-732-7671",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COSTILOW",
"first_name": "CAROLYN",
"middle_name": "CHAY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-24",
"last_updated": "2023-03-14",
"certification_date": "2023-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MS",
"license": "141317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oxford, MS
- Cornerstone Caregiving East LLC
- Cornerstone Rehabilitation of Oxford, Inc
- Cornerstone Rehabilitation of Univ-Oxf-Laf
- Samantha Corso, FNP-BC
- Cathy Diane Cossey, REGISTERED NURSE
- Lauren F Cotten, SLP
- Ira Lamar Couey, M.D.
- Covenant Counseling P.L.L.C.
- Covenant Sleep Clinic of Oxford, LLC
- Covenant Sleep Therapeutics
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.