Holly Jackson, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Southaven, MS

Holly Jackson, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Southaven, Mississippi. She graduated from nursing school in 2005 and has 19 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Mid-south Anesthesia Consultants, Pllc, American Anesthesiology Of Mississippi Llc and her current practice location is 7601 Southcrest Pkwy, Southaven, Mississippi. You can reach out to her office (for appointments etc.) via phone at (662) 772-4333.

Holly Jackson is licensed to practice in Mississippi (license number 901371) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1720575392.

Contact Information

Holly Jackson, CRNA
7601 Southcrest Pkwy,
Southaven, MS 38671-4739
(662) 772-4333
(855) 999-1345



Provider's Profile

Full NameHolly Jackson
GenderFemale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience19 Years
Location7601 Southcrest Pkwy, Southaven, Mississippi
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Holly Jackson graduated from nursing school in 2005
  NPI Data:
  • NPI Number: 1720575392
  • Provider Enumeration Date: 04/18/2018
  • Last Update Date: 04/18/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 0749539443
  • Enrollment ID: I20180814000453

Medical Identifiers

Medical identifiers for Holly Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1720575392NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 901371 (Mississippi)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Baptist Memorial Hospital DesotoSouthaven, MSHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Mid-south Anesthesia Consultants, Pllc024422319626
American Anesthesiology Of Mississippi Llc478905787823

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Holly Jackson allows following entities to bill medicare on her behalf.
Entity NameMid-south Anesthesia Consultants, Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003869520
PECOS PAC ID: 0244223196
Enrollment ID: O20040406001057

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Entity NameAmerican Anesthesiology Of Mississippi Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023723558
PECOS PAC ID: 4789057878
Enrollment ID: O20230311000163

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Holly Jackson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Holly Jackson, CRNA
7956 Vaughn Rd # 165,
Montgomery, AL 36116-6625

Ph: (888) 233-1493
Holly Jackson, CRNA
7601 Southcrest Pkwy,
Southaven, MS 38671-4739

Ph: (662) 772-4333

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Nurse Anesthetist, Certified Registered Nurses in Southaven, MS

Jonathan Wesley Reed, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 7601 Southcrest Pkwy, Southaven, MS 38671
Phone: 662-772-4333    
Jesse Clements,
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 391 Southcrest Cir Ste 108, Southaven, MS 38671
Phone: 901-484-8313    
Robert Lawrence Ryan, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 7580 Clarington Cv, Southaven, MS 38671
Phone: 662-349-9136    Fax: 662-349-0677
Steven Keith Owens, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 7601 Southcrest Pkwy, Southaven, MS 38671
Phone: 662-349-2659    Fax: 662-349-2653
Nikkita Shanee Robinson, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 7601 Southcrest Pkwy, Southaven, MS 38671
Phone: 662-772-4333    Fax: 855-999-1345
Morgan Thomas Smith,
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 391 Southcrest Cir Ste 108, Southaven, MS 38671
Phone: 662-349-2659    
Angela D. Mccoy, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 7601 Southcrest Pkwy, Southaven, MS 38671
Phone: 662-772-4333    Fax: 334-244-1830

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