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

Jake Martin Penick, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1376306480

Jake Martin Penick, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Jackson, Mississippi. Qualified in 2023, 3 years ago. Practices with Perioperative Services of Mississippi, LLC, a 98-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
3
Licensed in
MS
In the registry since
2024
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

1225 N State St
Jackson, MS 39202-2064
Phone: (601) 968-1000
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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 901900 (MS)

Record details

NPI number1376306480
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedFebruary 1, 2024
Last updated in NPPESFebruary 7, 2024
Certification dateFebruary 7, 2024

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Perioperative Services Of Mississippi, Llc — 98 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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