MR. DALE P HOTARD III CRNA
NPI 1609314400
Nurse Anesthetist, Certified Registered in Vicksburg, MS

Active since February 01, 2017Accepts Medicare Assignment
103 FAIRVIEW DR, VICKSBURG, MS 39180(314) 258-1988 Get Directions Write a Review

NPPES record last updated: September 17, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 17, 2025, Feb 1, 2017 (2 updates tracked since 2017).

About Mr. Dale P Hotard Iii Crna NPPES

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

MR. DALE P HOTARD III CRNA (NPI 1609314400) is an individual nurse anesthetist, certified registered in Vicksburg, Mississippi, licensed in Mississippi (901422) and active in the NPI registry since February 2017. He is affiliated with Jewish Hospital & St Mary's Healthcare, maintains a secondary practice location in Louisville, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1609314400
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameMR. DALE P HOTARD IIICredential: CRNA
Location Address103 FAIRVIEW DRVicksburg, MS 39180-8934
Mailing Address103 Fairview DrVicksburg, MS 39180-8934
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateFebruary 1, 2017
Last NPPES UpdateSeptember 17, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 17, 2025
NPI 1609314400 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
Licenses Licensed in MS · 901422 Licensed in KY · 4045094
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.

103 FAIRVIEW DR, Vicksburg, MS 39180

Secondary Practice Location 1

Location 1530 S Jackson StLouisville, KY 40202-1675 · Phone (502) 852-5851

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mr. Dale P Hotard Iii Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113295528
PECOS Enrollment IDI20170607002058, I20251013002829

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for x-ray or radiation therapy 01922
Anesthesia for x-ray or radiation therapy involves administering medication to help you relax or sleep during the procedure. It's used to ensure comfort, minimize movement, and reduce anxiety. The type of anesthesia used depends on the procedure and patient's health.
20 services18 patients
Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731
This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.
13 services13 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jewish Hospital & St Mary's Healthcare

Acute Care Hospitals · Louisville, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180040
Location200 Abraham Flexner WayLouisville, KY 40202 · Jefferson County
Emergency services

University Of Louisville Hospital

Acute Care Hospitals · Louisville, KY
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180141
Location530 South Jackson StreetLouisville, KY 40202 · Jefferson County
Emergency services Birthing friendly

Merit Health River Region

Acute Care Hospitals · Vicksburg, MS
2/5 CMS rating
OwnershipProprietary
CMS Certification Number250031
Location2100 Hwy 61 NVicksburg, MS 39183 · Warren County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39180 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$120.41 typical visit price
range $51.65 – $159.18
Typical copayment $30.10 (range $12.91 – $39.79)
Most-billed visit code 99204
Established Patient
$64.96 typical visit price
range $16.15 – $129.61
Typical copayment $16.24 (range $4.03 – $32.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609314400, enumerated as an "individual" on February 01, 2017.

The provider is located at 103 FAIRVIEW DR VICKSBURG, MS 39180 and the phone number is (314) 258-1988.

Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.

Dale Hotard is affiliated with: JEWISH HOSPITAL & ST MARY'S HEALTHCARE, UNIVERSITY OF LOUISVILLE HOSPITAL and MERIT HEALTH RIVER REGION.