Mr Channon Lee Pruitt, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Vicksburg, MS

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Mr Channon Lee Pruitt, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Vicksburg, Mississippi. He graduated from nursing school in 2002 and has 22 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Jackson Anesthesia Associates Pa, Perioperative Services Of Mississippi, Llc and his current practice location is 2100 Highway 61 N, Vicksburg, Mississippi. You can reach out to his office (for appointments etc.) via phone at (601) 883-5000.

Mr Channon Lee Pruitt is licensed to practice in Mississippi (license number R865866) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1265644710.

Contact Information

Mr Channon Lee Pruitt, CRNA
2100 Highway 61 N,
Vicksburg, MS 39183-8211
(601) 883-5000
Not Available

Map and Direction




Provider's Profile

Full NameMr Channon Lee Pruitt
GenderMale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience22 Years
Location2100 Highway 61 N, Vicksburg, Mississippi
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mr Channon Lee Pruitt graduated from nursing school in 2002
  NPI Data:
  • NPI Number: 1265644710
  • Provider Enumeration Date: 05/05/2007
  • Last Update Date: 07/10/2014
  Medicare PECOS Information:
  • PECOS PAC ID: 1850457284
  • Enrollment ID: I20120601000225

Medical Identifiers

Medical identifiers for Mr Channon Lee Pruitt such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1265644710NPI-NPPES
00604005MedicaidMS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered R865866 (Mississippi)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Merit Health River OaksFlowood, MSHospital
Mississippi Baptist Medical CenterJackson, MSHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Jackson Anesthesia Associates Pa387058590430
Perioperative Services Of Mississippi, Llc892136525593

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. Mr Channon Lee Pruitt allows following entities to bill medicare on his behalf.
Entity NameMedical Foundation Of Central Mississippi Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1992774814
PECOS PAC ID: 1153216411
Enrollment ID: O20040217000380
Entity NameJackson Anesthesia Associates Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780737577
PECOS PAC ID: 3870585904
Enrollment ID: O20040331000285
Entity NameAnesthesia Consultants Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750300836
PECOS PAC ID: 4486637881
Enrollment ID: O20040608000711
Entity NameWillow Anesthesia Services, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1205169521
PECOS PAC ID: 9234279183
Enrollment ID: O20091228000308
Entity NameNorthstar Anesthesia Of Mississippi Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1124415567
PECOS PAC ID: 1658682117
Enrollment ID: O20150624002329
Entity NamePerioperative Services Of Mississippi, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1881123123
PECOS PAC ID: 8921365255
Enrollment ID: O20171122000010

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. Mr Channon Lee Pruitt 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
Mr Channon Lee Pruitt, CRNA
74 Lake Barnett Dr,
Brandon, MS 39047-6278

Ph: () -		Mr Channon Lee Pruitt, CRNA
2100 Highway 61 N,
Vicksburg, MS 39183-8211

Ph: (601) 883-5000

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Vicksburg, MS

Mr. Michael J Mcreynolds, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183
Phone: 601-831-1146    
Richard M Stone Jr., CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183
Phone: 601-883-5000    
Christopher Sumrall,
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183
Phone: 601-218-6136    
Melanie Joan Waldrop, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2100 Hwy 61n, River Region Medical Center, Vicksburg, MS 39183
Phone: 601-883-5000    
Mr. Michael Edward Killen, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183
Phone: 601-883-5707    
Jackie L Benson, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183
Phone: 601-883-5000    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.