Individual provider Active NPI

Jordan Colby Kirkland, CRNA

  • Certified Registered Nurse Anesthetist
  • Pascagoula, MS
National Provider Identifier
1962974022
Registry record updated Jul 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
901785 Issued in MS
Practice address
2809 Denny Ave
Pascagoula, MS 39581-5301
Phone
(228) 809-5540
Fax
(228) 809-1153
NPI assigned
Dec 28, 2018
Last updated
Jul 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-148131 AL
Certified Registered Nurse Anesthetist 367500000X 901785 MS Primary

Addresses

Primary practice location

2809 Denny Ave
Pascagoula, MS 39581-5301

Mailing address

11071D Highway 188
Grand Bay, AL 36541-6219
Phone (251) 802-5926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190318002896 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0244570844 Reassigns benefits to 2 organizations
I20220826001991 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 0244570844 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
USA Health Anesthesia Billing Services LLCGroup PAC ID 1153659123, 160 clinicians
Singing River Health SystemGroup PAC ID 3870405194, shared by 10 NPIs, 290 clinicians

Practice addresses (Care Compare)

2451 Fillingim St
Mobile, AL 36617-2238
Phone (251) 471-7000

2809 Denny Ave
Pascagoula, MS 39581-5301

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
901785MSMDFamily Nurse Practitioner
1-148131ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Gulfport CurrentSince Jul 22, 2022 Accepting new patients
University of South Alabama Nurse Anesthetist, Certified Registered CurrentSince Jan 14, 2019 Accepting new patients
University of South Alabama Nurse Anesthetist, Certified Registered CurrentSince Jan 14, 2019 Accepting new patients
Coastal Anesthesia, P.C. CurrentSince Apr 15, 2024 Accepting new patients
USA Health Anesthesia Billing Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2019 Accepting new patients
Singing River Gulfport CurrentSince Jan 1, 2023 Accepting new patients
Singing River Gulfport CurrentSince Jul 22, 2022 Accepting new patients
Jackson County Anesthesia CurrentSince May 1, 2023 Accepting new patients

Locations

1700 Center St
Mobile, AL 36604
Phone (251) 415-1000

2451 Fillingim St
Mobile, AL 36617
Phone (251) 434-3711

3610 Springhill Memorial Dr N
#D
Mobile, AL 36608
Phone (251) 342-3000

2101 Highway 90
Gautier, MS 39553
Phone (228) 497-7576

15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000

350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054

3109 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 818-1100

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1545955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657411200000",
    "number": "1962974022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11071D HIGHWAY 188",
            "city": "GRAND BAY",
            "state": "AL",
            "postal_code": "365416219",
            "telephone_number": "251-802-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 DENNY AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815301",
            "telephone_number": "228-809-5540",
            "fax_number": "228-809-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKLAND",
        "first_name": "JORDAN",
        "middle_name": "COLBY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-28",
        "last_updated": "2022-07-10",
        "certification_date": "2022-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-148131",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "901785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pascagoula, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2022; 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.