Callie Bridges, CRNA

Individual provider Active NPI Certified Registered Nurse Anesthetist · Jackson, MS

NPI 1801436951 · NPPES record last updated Jan 7, 2020

Key facts

NPI
1801436951
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
894377 (MS)
Practice address
969 Lakeland Dr
Jackson, MS 39216-4606
Phone
(601) 200-2000
NPI assigned
Jan 7, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Anesthesia Group, P.a. (54 clinicians)

Practice addresses (Care Compare)

971 Lakeland Dr
Jackson, MS 39216-4643
Phone (601) 200-2000

Hospital & facility affiliations

  • St Dominic-Jackson Memorial Hospital Hospital · Jackson, MS · CCN 250048

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200225001953 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860829298 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
894377MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Anesthesia Group, P.a. Current
since Feb 1, 2020
Accepting new patients

Locations

971 Lakeland Dr
Jackson, MS 39216
Phone (601) 939-5922

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 894377 MS Yes

Addresses

Primary practice location

969 Lakeland Dr
Jackson, MS 39216-4606

Mailing address

PO Box 235019
Montgomery, AL 36123-5019

Other providers in Jackson, MS

All providers in Jackson, MS · Certified Registered Nurse Anesthetist in Mississippi

Sources for this page

Verify at the official NPI Registry.