NPIMap

Organization Active NPI

Physicians Anesthesia Group Staffing, LLC

  • Anesthesiology Physician
  • Jackson, MS
National Provider Identifier
1558102772
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PHYSICIANS ANESTHESIA GROUP STAFFING, LLC
Practice address
971 Lakeland Dr Ste 202
Jackson, MS 39216-4607
Phone
(601) 362-1990
NPI assigned
Jun 3, 2024
Last updated
May 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Authorized official

Name
Ryan Bruce Weathers
Title
Manager
Phone
(334) 425-1583

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary
Certified Registered Nurse Anesthetist 367500000X NU

Addresses

Primary practice location

971 Lakeland Dr Ste 202
Jackson, MS 39216-4607

Mailing address

7956 Vaughn Rd Ste 165
Montgomery, AL 36116-6819
Phone (601) 277-0060

Other names 1

  • PAG Staffing Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240725002689 MS Part B Supplier - Clinic/Group Practice 2769928795 Receives reassigned benefits from 30 practitioners
Practice locations: Jackson, MS; Madison, MS; Flowood, MS

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 63

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778544000000",
    "number": "1558102772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7956 VAUGHN RD STE 165",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361166819",
            "telephone_number": "601-277-0060",
            "fax_number": "866-502-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR STE 202",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164607",
            "telephone_number": "601-362-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS ANESTHESIA GROUP STAFFING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-03",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A",
        "authorized_official_last_name": "WEATHERS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "334-425-1583"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAG Staffing",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "PAG Staffing",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.