Individual provider Active NPI

Kelly R O'Reilly, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, MS
National Provider Identifier
1558599837
Registry record updated May 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
081436 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-5900
NPI assigned
Jun 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2016

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 081436 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

220 Johnstone Dr.
Madison, MS 39110
Phone (601) 707-7039

Other identifiers 2

IdentifierTypeStateIssuer
2179942MedicaidLA
P01629810OtherMSRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101202000625 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931395910 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consultants PAGroup PAC ID 4486637881, 102 clinicians
Gi Alliance Anesthesia of Mississippi PLLCGroup PAC ID 3173963949, 28 clinicians

Practice addresses (Care Compare)

1030 River Oaks Dr
Flowood, MS 39232-9553
Phone (601) 932-1030

2510 Lakeland Dr
Flowood, MS 39232-9513
Phone (604) 355-1234

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.9 of 100Reported as group
Quality
47.44
Promoting interoperability
98
Improvement activities
40
Cost
77.24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
081436MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
State of Mississippi-University of Mississippi Medical Center Nurse Anesthetist, Certified Registered CurrentSince Oct 6, 2010 Accepting new patients
Gi Alliance Anesthesia of Mississippi PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2024 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Oct 6, 2010 Accepting new patients
Jackson Anesthesia Associates PA CurrentSince Jul 15, 2021 Accepting new patients
Gastrointestinal Associates, PA Nurse Anesthetist, Certified Registered CurrentSince Aug 17, 2020 Accepting new patients
Gastrointestinal Associates, P.a. Current Accepting new patients
Anesthesia Consultants PA Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2020 Accepting new patients

Locations

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

2510 Lakeland Dr
Flowood, MS 39232
Phone (601) 355-1234

965 Avent Dr
Ste 100A
Grenada, MS 38901
Phone (662) 227-7000

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

1030 River Oaks Dr
Jackson, MS 39232
Phone (601) 376-2165

1421 N State St
Ste 203
Jackson, MS 39202
Phone (601) 355-1234

239 Bowling Green Rd
Lexington, MS 39095
Phone (662) 834-1321

106 Highland Way
Ste 101
Madison, MS 39110
Phone (601) 355-1234

Organizations & group practices 8

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 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": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462924800000",
    "number": "1558599837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 JOHNSTONE DR.",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "39110",
            "telephone_number": "601-707-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'REILLY",
        "first_name": "KELLY",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2016-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "081436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2179942",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01629810",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 11, 2016; 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.