Charles Ezelle, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R880502 Issued in MS

Practice address

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

Phone

(662) 550-4299

Fax

(662) 580-4324

NPI assigned

Aug 31, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2015

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)

Hospital & facility affiliations

• University of Mississippi Medical Center- Grenada Hospital, Grenada, MS, CCN 250168

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Willow Anesthesia Services LLC

  • Certified Registered Nurse Anesthetist
  • Oxford, MS
  • NPI 1205169521

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Anesthesia Consultants PA

  • Anesthesiology Physician
  • Jackson, MS
  • NPI 1750300836

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Perioperative Services of Mississippi, LLC

  • Anesthesiology Physician
  • Jackson, MS
  • NPI 1881123123
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• State of Mississippi-University of Mississippi Medical Center

  • Psychiatric Hospital
  • Grenada, MS
  • NPI 1083041917
  Care Compare affiliation
• State of Mississippi-University of Mississippi Medical Center

  • General Acute Care Hospital
  • Grenada, MS
  • NPI 1558798603
  Care Compare affiliation

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1932576550",
    "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",
            "fax_number": "662-580-4324"
        },
        {
            "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",
            "fax_number": "662-580-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZELLE",
        "first_name": "CHARLES",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R880502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isham Harrison Evans, M. D.
• Jeffrey Neal Evans, MD
• Tanya Evans, RN
• Courtney Everett
• Angela Denise Evins, M.S.
• Jeannie (None) Falkner, PHD
• Family Cancer Center, PLLC
• Farese Family Dental
• Molly Barbieri Farmer, LCSW
• William Doty Farmer, MD

• Certified Registered Nurse Anesthetist in Oxford, MS
• Providers in Oxford, MS by specialty
• Certified Registered Nurse Anesthetist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.