Individual provider Active NPI

John David Maharrey, CRNA

  • Certified Registered Nurse Anesthetist
  • Oxford, MS
National Provider Identifier
1689019929
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
22072 Issued in TN
Practice address
2704 W Oxford Loop
Suite 117
Oxford, MS 38655-5714
Phone
(662) 550-4299
NPI assigned
Apr 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0024171086 VA
Certified Registered Nurse Anesthetist 367500000X A810705 MS
Registered Nurse 163W00000X 163517 TN
Certified Registered Nurse Anesthetist 367500000X 22072 TN Primary

Addresses

Primary practice location

2704 W Oxford Loop
Suite 117
Oxford, MS 38655-5714

Mailing address

2704 W Oxford Loop
Suite 117
Oxford, MS 38655-5714
Phone (662) 550-4299

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150930002761 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 8426292350 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willow Anesthesia Services LLCGroup PAC ID 9234279183, 52 clinicians

Practice addresses (Care Compare)

2100 Exeter Rd
Suite 200
Germantown, TN 38138-3966
Phone (901) 699-4436

960 Avent Dr
Grenada, MS 38901-5230
Phone (662) 227-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
163517TNMDRegistered Nurse
A810705MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 11, 2015 Accepting new patients

Locations

960 Avent Dr
Grenada, MS 38901
Phone (662) 227-7000

499 Azalea Dr
Oxford, MS 38655
Phone (662) 234-7979

2704 West Oxford Loop
Ste 117
Oxford, MS 38655
Phone (662) 550-4299

Organizations & group practices 2

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 2

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": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1689019929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 W OXFORD LOOP",
            "address_2": "SUITE 117",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555714",
            "telephone_number": "662-550-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 W OXFORD LOOP",
            "address_2": "SUITE 117",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555714",
            "telephone_number": "662-550-4299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHARREY",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-30",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024171086",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "A810705",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "163517",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "22072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.