Individual provider Active NPI

John Henry Biddle Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Ridgeland, MS
National Provider Identifier
1669473575
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R702838 Issued in MS
Practice address
102 Westfield Rd
Ridgeland, MS 39157-9750
Phone
(601) 853-0842
NPI assigned
Aug 2, 2005
Last updated
Sep 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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 R702838 MS Primary

Addresses

Primary practice location

102 Westfield Rd
Ridgeland, MS 39157-9750

Mailing address

102 Westfield Rd
Ridgeland, MS 39157-9750
Phone (601) 853-0842

Other identifiers 1

IdentifierTypeStateIssuer
00116286MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200121000096 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214945351 Reassigns benefits to 3 organizations
I20211207001920 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214945351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Street Anesthesia of New Mexico, LLCGroup PAC ID 3476807538, 228 clinicians

Practice addresses (Care Compare)

601 Dr Martin Luther King Jr Ave NE
Lovelace Medical Center
Albuquerque, NM 87102-3619
Phone (505) 727-8000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R702838MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jan 15, 2020 Accepting new patients
Main Street Anesthesia of New Mexico, LLC CurrentSince Sep 3, 2021 Accepting new patients
Wellspan Medical Group CurrentSince Jan 15, 2020 Accepting new patients
Lehigh Anesthesia Associates, P.C. CurrentSince Dec 1, 2019 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Hershey Endoscopy Center, LLC CurrentSince Jan 15, 2020 Accepting new patients
Hershey Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 15, 2020 Accepting new patients
Surgical Anesthesia Associates, PA Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

117 E 19th St
Roswell, NM 88201
Phone (505) 727-2000

5100 W Tilghman St
Ste 315
Allentown, PA 18104
Phone (610) 395-4044

905 W Governor Rd
Ste 100
Hershey, PA 17033
Phone (717) 531-1318

875 Norman Dr
Lebanon, PA 17042
Phone (717) 272-2010

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1669473575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WESTFIELD RD",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391579750",
            "telephone_number": "601-853-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WESTFIELD RD",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391579750",
            "telephone_number": "601-853-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIDDLE",
        "first_name": "JOHN",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R702838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00116286",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; 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.