Individual provider Active NPI

Jared Scott Seymour, CRNA

  • Certified Registered Nurse Anesthetist
  • Hattiesburg, MS
National Provider Identifier
1639620883
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
901415 Issued in MS
Practice address
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone
(601) 261-3606
Fax
(601) 579-5383
NPI assigned
Oct 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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 901415 MS Primary

Addresses

Primary practice location

415 S 28TH Ave
Hattiesburg, MS 39401-7246

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 261-3606

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170123001339 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 8426330762 Reassigns benefits to 8 organizations

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
Singing River GulfportGroup PAC ID 5294154829, shared by 3 NPIs, 75 clinicians
Jackson County AnesthesiaGroup PAC ID 9931292729, 37 clinicians

Practice addresses (Care Compare)

15200 Community Rd
Gulfport, MS 39503-3085
Phone (228) 575-7000

2809 Denny Ave
Pascagoula, MS 39581-5301
Phone (228) 809-5000

Hospital & facility affiliations

  • Singing River Gulfport Hospital, Gulfport, MS, CCN 250123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
901415MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport CurrentSince Sep 25, 2017 Accepting new patients
Singing River Gulfport CurrentSince Aug 10, 2021 Accepting new patients
Singing River Health System CurrentSince Oct 13, 2022 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Singing River Health System CurrentSince Oct 15, 2018 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 18, 2022 Accepting new patients
Jackson County Anesthesia CurrentSince May 1, 2023 Accepting new patients
Singing River Gulfport CurrentSince Jan 1, 2023 Accepting new patients
Etas, PLLC CurrentSince Jul 1, 2024 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Sep 25, 2017 Accepting new patients

Locations

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054

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

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

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

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

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

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

3109 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 818-1100

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

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 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": "1477008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1639620883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-261-3606",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-261-3606",
            "fax_number": "601-579-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYMOUR",
        "first_name": "JARED",
        "middle_name": "SCOTT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-21",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "901415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; 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.