Individual provider Active NPI

Brian Douglas Haak, CRNA

  • Certified Registered Nurse Anesthetist
  • Southaven, MS
National Provider Identifier
1730141771
Registry record updated Jul 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN A810134 Issued in MS
Practice address
9140 Highway 51 N
Southaven, MS 38671-1233
Phone
(662) 280-8222
Fax
(662) 280-5541
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2009

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 APRN A810134 MS Primary

Addresses

Primary practice location

9140 Highway 51 N
Southaven, MS 38671-1233

Mailing address

PO Box 740209
Dept 40038
Atlanta, GA 30374-0209
Phone (941) 360-1566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
82921TXMDProfessional Counselor
244ARMDPhysical Therapist
APRN A810134MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ahp of Orlando Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Outpatient Specialists Past Accepting new patients
Mitchell County Hospital District Past Accepting new patients
Ahp of Central Florida ASC LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Health Care Partners of Florida Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Ahp of Altamonte Springs LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247184000000",
    "number": "1730141771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740209",
            "address_2": "DEPT 40038",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740209",
            "telephone_number": "941-360-1566",
            "fax_number": "941-358-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9140 HIGHWAY 51 N",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386711233",
            "telephone_number": "662-280-8222",
            "fax_number": "662-280-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAK",
        "first_name": "BRIAN",
        "middle_name": "DOUGLAS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2009-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "APRN A810134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.