JIMMY R JACKSON CRNA
NPI 1164449658
Nurse Anesthetist, Certified Registered in Tupelo, MS

Q: What is Jimmy Jackson's NPI number?

The NPI number for Jimmy Jackson is 1164449658. It was assigned to this individual provider in the NPPES registry on July 17, 2006.

Q: What is Jimmy Jackson's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Q: When was this NPI record last updated?

The NPPES record for Jimmy Jackson was last updated on November 9, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 17, 2006

830 SOUTH GLOSTER, TUPELO, MS 38801(662) 377-4394(662) 377-7045 Get Directions Write a Review

NPPES record last updated: November 9, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jimmy R Jackson Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JIMMY R JACKSON CRNA (NPI 1164449658) is an individual nurse anesthetist, certified registered in Tupelo, Mississippi, licensed in Mississippi (R539929) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1164449658

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameJIMMY R JACKSONCredential: CRNA

Location Address830 SOUTH GLOSTERTupelo, MS 38801

Mailing AddressPo Box 3294Tupelo, MS 38803-3294 · (662) 377-4394 · Fax (662) 377-7045

Phone(662) 377-4394

Fax(662) 377-7045

Sole ProprietorNo

Enumeration DateJuly 17, 2006

Last NPPES UpdateNovember 9, 2010

✔ NPI 1164449658 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in MS · R539929

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

830 SOUTH GLOSTER, Tupelo, MS 38801

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Other Identifiers 4

Medicaid00110004MS

Medicare UPINR34681

Medicaid009936743AL

Medicare ID-Type Unspecified430001934MS

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARAH COTTON ASHMORE CRNA