Individual provider Active NPI

Michael C Roberson, CRNA

  • Certified Registered Nurse Anesthetist
  • Madison, MS
National Provider Identifier
1669508263
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R853495 Issued in MS
Practice address
1026 Baptist Cir Ste 101
Madison, MS 39110-2028
Phone
(601) 668-4938
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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 R853495 MS Primary

Addresses

Primary practice location

1026 Baptist Cir Ste 101
Madison, MS 39110-2028

Mailing address

455 Crossgates Blvd Apt 232
Brandon, MS 39042-2560
Phone (601) 668-4938

Other identifiers 1

IdentifierTypeStateIssuer
00125458MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110512000121 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 3375430747 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consultants PAGroup PAC ID 4486637881, 102 clinicians
Physicians Anesthesia Group Staffing, LLCGroup PAC ID 2769928795, 21 clinicians
Perioperative Services of Mississippi, LLCGroup PAC ID 8921365255, 98 clinicians

Practice addresses (Care Compare)

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

1190 N State St
Jackson, MS 39202-2413
Phone (601) 968-1790

1225 N State St
Ms Baptist Medical Center
Jackson, MS 39202-2064
Phone (601) 317-2802

Hospital & facility affiliations

  • Merit Health River Oaks Hospital, Flowood, MS, CCN 250138

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R853495MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Perioperative Services of Mississippi, LLC CurrentSince Jun 1, 2023 Accepting new patients
Anesthesia Consultants PA Nurse Anesthetist, Certified Registered CurrentSince Apr 15, 2024 Accepting new patients
Medical Foundation of Central Mississippi, Inc. CurrentSince Dec 31, 2011 Accepting new patients
Medical Foundation of Central Ms CurrentSince Dec 31, 2011 Accepting new patients
Mississippi Baptist Medical Center, Inc. CurrentSince Jan 1, 1989 Accepting new patients
Jackson Anesthesia Associates PA CurrentSince May 1, 2017 Accepting new patients
Physicians Anesthesia Group Staffing, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 17, 2024 Accepting new patients
Mississippi Baptist Medical Center, Inc. CurrentSince Jan 1, 1989 Accepting new patients

Locations

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500

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

501 Marshall St
Ste 301
Jackson, MS 39202

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

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

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383

1026 Baptist Cir
Ste 101
Madison, MS 39110
Phone (601) 353-2020

2100 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-5001

Interoperability endpoints

  • Direct secure messaging: mroberson219397@ummc.direct-ci.com

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1669508263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 CROSSGATES BLVD APT 232",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422560",
            "telephone_number": "601-668-4938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 BAPTIST CIR STE 101",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391102028",
            "telephone_number": "601-668-4938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R853495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125458",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; 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.