MISSISSIPPI ANESTHESIA GROUP, LLC
NPI 1366845554
Nurse Anesthetist, Certified Registered in Canton, MS
NPI Status: Active since October 01, 2014
Contact Information
145 SANCTUARY LN
CANTON, MS
ZIP 39046
Phone: (601) 855-7440
- Organization
- Nurse Anesthetist, Certified Registered
- CLIA Number: 25D2177508
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 01-12-2026
About MISSISSIPPI ANESTHESIA GROUP, LLC
This page provides the complete NPI Profile along with additional information for Mississippi Anesthesia Group, Llc, a provider established in Canton, Mississippi operating as a Nurse Anesthetist, Certified Registered. The healthcare provider is registered in the NPI registry with number 1366845554 assigned on October 2014. The practitioner's primary taxonomy code is 367500000X with license number R598755 (MS). The provider is registered as an organization and their NPI record was last updated 12 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Gary Dwayne Self Crna (Founder And President)
- NPI
- 1366845554
- Provider Name
- MISSISSIPPI ANESTHESIA GROUP, LLC
- Entity Type
- Organization
- Location Address
- 145 SANCTUARY LN CANTON, MS 39046
- Location Phone
- (601) 855-7440
- Mailing Address
- 2714 W OXFORD LOOP STE 161 OXFORD, MS 38655
- Mailing Phone
- (662) 550-4299
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-01-2014
- Last Update Date
- 10-01-2014
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Anesthetist, Certified Registered
- Taxonomy Code
- 367500000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- R598755
- License State
- MS
- Taxonomy Description
- (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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 25D2177508
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- January 13, 2024
- Certificate Expiration Date
- January 12, 2026
- Laboratory Director
- KRISTINE PRUITT
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Mississippi Anesthesia Group, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1366845554, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 56 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1366845554, enumerated as an "organization" on October 01, 2014.
The provider is located at 145 SANCTUARY LN CANTON, MS 39046 and the phone number is (601) 855-7440.
Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
