Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Chaka Jackson

Individual provider Certified Registered Nurse Anesthetist · NPI 1922683580

Chaka Jackson is a Certified Registered Nurse Anesthetist (CRNA) in Hattiesburg, Mississippi. Qualified in 2020, 6 years ago. Practices with Hattiesburg Clinic PA, a 530-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
6
Licensed in
MS
In the registry since
2021
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Practice location Address checks out

415 S 28th Ave
Hattiesburg, MS 39401-7246
Phone: (601) 261-3606
Fax: (601) 579-5240
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 901694 (MS)

Record details

NPI number1922683580
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 16, 2021
Last updated in NPPESSeptember 13, 2021
Certification dateSeptember 13, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Hattiesburg Clinic Pa — 530 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Hattiesburg