Individual provider Active NPI

Nicholas Grant Smith, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Temple, TX
National Provider Identifier
1003188699
Registry record updated May 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
814527 Issued in TX
Practice address
2401 S 31St St
Temple, TX 76504-7115
Phone
(254) 724-2111
NPI assigned
Jan 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 120081 LA
Certified Registered Nurse Anesthetist 367500000X 814527 TX Primary

Addresses

Primary practice location

2401 S 31St St
Temple, TX 76504-7115

Mailing address

2803 Ira Young Dr
Apt 3111
Temple, TX 76504-6323
Phone (225) 202-3797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180124002711 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587828462 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dpi of Louisiana LLCGroup PAC ID 1456886365, 72 clinicians

Practice addresses (Care Compare)

17000 Medical Ctr Dr
Baton Rouge, LA 70816-3246
Phone (225) 752-2470

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
120081LAMDCertified Registered Nurse Anesthetist
AP06743LAMDCertified Registered Nurse Anesthetist
814527TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Dpi of Louisiana LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2024 Accepting new patients
Diversified Professionals, Inc. CurrentSince Sep 1, 2021 Accepting new patients
Anesthesiology Group Associates Inc CurrentSince Dec 19, 2017 Accepting new patients

Locations

8946 Interline Ave
Ste C
Baton Rouge, LA 70809
Phone (225) 529-1143

7777 Hennessy Blvd
Ste 301
Baton Rouge, LA 70808
Phone (225) 214-6436

17000 Medical Center Dr
Baton Rouge, LA 70816
Phone (225) 752-2470

11414 Lake Sherwood Ave N
Baton Rouge, LA 70816
Phone (225) 532-4058

7301 Hennessy Blvd
#100
Baton Rouge, LA 70808
Phone (225) 215-3443

9032 Perkins Rd
Baton Rouge, LA 70810
Phone (225) 358-4853

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

6550 Main St
Ste 2600
Zachary, LA 70791
Phone (225) 570-6357

6300 Main St
Zachary, LA 70791
Phone (225) 570-2618

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336435200000",
    "number": "1003188699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2803 IRA YOUNG DR",
            "address_2": "APT 3111",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765046323",
            "telephone_number": "225-202-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765047115",
            "telephone_number": "254-724-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICHOLAS",
        "middle_name": "GRANT",
        "name_prefix": "Mr.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-30",
        "last_updated": "2012-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "120081",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "814527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.