Justin Gaddis, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

151866 Issued in TX

Practice address

800 E Dawson St
Tyler, TX 75701-2036

Phone

(903) 593-8441

NPI assigned

Jan 7, 2013

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sweet Dreams Anesthesia PLLCGroup PAC ID 1254757685, 19 clinicians

Anesthesia Consultants PAGroup PAC ID 4486637881, 102 clinicians

Perioperative Services of Mississippi, LLCGroup PAC ID 8921365255, 98 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102
• Merit Health River Oaks Hospital, Flowood, MS, CCN 250138

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.

• Anesthesia Consultants PA

  • Anesthesiology Physician
  • Jackson, MS
  • NPI 1750300836

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Perioperative Services of Mississippi, LLC

  • Anesthesiology Physician
  • Jackson, MS
  • NPI 1881123123
  Medicare reassignment Care Compare group NPD
• Sweet Dreams Anesthesia, PLLC

  • Certified Registered Nurse Anesthetist
  • Meridian, MS
  • NPI 1427667724

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Jackson Anesthesia Associates PA

  • Anesthesiology Physician
  • Jackson, MS
  • NPI 1780737577
  Medicare reassignment NPD

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

• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  Care Compare affiliation
• River Oaks Hospital LLC

  • General Acute Care Hospital
  • Flowood, MS
  • NPI 1396792032
  Care Compare affiliation

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1992042246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841656",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752841656",
            "telephone_number": "903-531-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E DAWSON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012036",
            "telephone_number": "903-593-8441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDIS",
        "first_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-07",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "151866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8305UE",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-015",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD",
            "identifier": "P01200603",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fyzical Therapy & Balance Center Tyler PLLC
• G P Goodfried MD PA
• Amanda Gaar, OTR
• Amy Gaddis
• John Gaddis
• Howell R Gaddy, MD
• Stephanie Gage, PTA
• Nancy L Gailey
• Lisa Gaines
• Rickiesha M Gaines

• Certified Registered Nurse Anesthetist in Tyler, TX
• Providers in Tyler, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; 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.