Southcrest Anesthesia Services, PLLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R691259 Issued in MS

Legal business name

SOUTHCREST ANESTHESIA SERVICES, PLLC

Practice address

7580 Clarington CV
Southaven, MS 38671-5657

Phone

(662) 349-9136

Fax

(662) 349-0677

NPI assigned

Sep 2, 2006

Organization subpart

No

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

Authorized official

Name

Robert Lawrence Ryan, CRNANPI 1215039979

Title

Owner Practice Manager

Phone

(662) 349-9136

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Lawrence Ryan, CRNA

  • Certified Registered Nurse Anesthetist
  • Southaven, MS
  • NPI 1215039979

  Nurse Anesthetist, Certified Registered

  NPD (past) Authorized official

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1942302617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1430",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386710015",
            "telephone_number": "662-349-9136",
            "fax_number": "662-349-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 CLARINGTON CV",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715657",
            "telephone_number": "662-349-9136",
            "fax_number": "662-349-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHCREST ANESTHESIA SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-02",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "OWNER PRACTICE MANAGER",
        "authorized_official_telephone_number": "662-349-9136",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R691259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015237",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southaven Hearing Health Center LLP
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• Southaven Services
• Southaven Sleep Clinic
• Southaven Surgery Center LLC
• Southcrest Women Healthcare
• Southeast Urology Network PC
• Southern Home Care
• Southern Orthodontic Specialists, P.C.
• Southgate Durable Medical Equipments

• Certified Registered Nurse Anesthetist in Southaven, MS
• Providers in Southaven, 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 Apr 20, 2008; 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.