Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1164523973

Unknown Individual is a healthcare provider. based in Mccomb, Mississippi. specializing in Certified Registered Nurse Anesthetist. They hold a License No. R570354 (MS). The NPI Number for Unknown Individual is 1164523973

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1164523973
Phone
(601) 249-5500
Address
215 MARION AVE
Deactivation Date
30 June 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Loading map...

Provider Addresses for Unknown Individual

  • Southwest Mississippi Regional Medical Center, 215, Marion Avenue, McComb, Pike County, Mississippi, 39648, United States

    MCCOMB, MS 396482705

    Phone: (601) 249-5500

    Fax: (601) 249-1709

    Type: Location

  • Hillshire Drive, Kirkville, McComb, Pike County, Mississippi, 39648, United States

    MCCOMB, MS 396482705

    Phone: (601) 249-2757

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 39648)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1164523973 for Unknown Individual.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Certified Registered Nurse Anesthetist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Mccomb, Mississippi. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

Similar Providers

GERALD TODD ADCOCK (CRNA)

Certified Registered Nurse Anesthetist
Southwest Mississippi Regional Medical Center, 215, Marion Avenue, McComb, Pike County, Mississippi, 39648, United States
NPI: 1821046145
427 HIGHWAY 51 N
NPI: 1417909003

MCCOMB ANESTHESIA ASSOCIATES, LLP

Anesthesiology Physician
Jackson Post Office, South West Street, Jackson, Hinds County, Mississippi, 39201, United States
NPI: 1619916533

MR. HUGH RUSSELL JR. FORTENBERRY (CRNA)

Certified Registered Nurse Anesthetist
Southwest Mississippi Regional Medical Center, 215, Marion Avenue, McComb, Pike County, Mississippi, 39648, United States
NPI: 1003844481

MRS. SARAH DART ANDREWS (CRNA)

Certified Registered Nurse Anesthetist
Southwest Mississippi Regional Medical Center, 215, Marion Avenue, McComb, Pike County, Mississippi, 39648, United States
NPI: 1215969431

MR. JASON TODD LANE (CRNA)

Certified Registered Nurse Anesthetist
Southwest Mississippi Regional Medical Center, 215, Marion Avenue, McComb, Pike County, Mississippi, 39648, United States
NPI: 1003827478

MR. RICHARD THOMAS LANE (CRNA)

Certified Registered Nurse Anesthetist
1210, Parklane Road, McComb, Pike County, Mississippi, 39648, United States
NPI: 1447261805

MR. GARY LEE JACOBS (CRNA)

Certified Registered Nurse Anesthetist
Southwest Mississippi Regional Medical Center, 215, Marion Avenue, McComb, Pike County, Mississippi, 39648, United States
NPI: 1861502155

MRS. CHRISTINA RAYBURN FORTENBERRY (CRNA)

Certified Registered Nurse Anesthetist
Southwest Mississippi Regional Medical Center, 215, Marion Avenue, McComb, Pike County, Mississippi, 39648, United States
NPI: 1902989700