Benjamin R. Wisenbaker, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP07907 Issued in LA

Practice address

1541 Kings Hwy
Shreveport, LA 71103-4228

Phone

(318) 626-0000

Fax

(318) 629-4833

NPI assigned

Jul 7, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, MI, OH, LA4 enrollments

Enrollment records 4

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Health Shreveport, LLCGroup PAC ID 7416207196, 64 clinicians

Associated Anesthesiologists of Fort Wayne PCGroup PAC ID 2264412444, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Lsu Health Shreveport Hospital, Shreveport, LA, CCN 190098
• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• University Health Shreveport LLC

  • Nurse Practitioner
  • Shreveport, LA
  • NPI 1619443611
  Medicare reassignment Care Compare group NPD
• Associated Anesthesiologists of Fort Wayne PC

  • Anesthesiology Physician
  • Fort Wayne, IN
  • NPI 1538159140

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Clinical Colleagues Inc

  • Anesthesiology Physician
  • Van Wert, OH
  • NPI 1992725766

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Community Health Center of Branch County

  • General Practice Physician
  • Coldwater, MI
  • NPI 1124055009
  Medicare reassignment NPD
• Iceland Anesthesia Management, LLC

  • Anesthesiology Physician
  • Terre Haute, IN
  • NPI 1912578667

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Jebs Anesthesia Consultants, LLC

  • Anesthesiology Physician
  • La Porte, IN
  • NPI 1790447761
  Medicare reassignment NPD
• Surgery One Anesthesia, LLC

  • Anesthesiology Physician
  • Fort Wayne, IN
  • NPI 1144724402
  Medicare reassignment NPD
• University Health Shreveport LLC

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
  • NPI 1629544622

  Nurse Anesthetist, Certified Registered

  NPD
• Community Health Center of Branch County

  • Hematology & Oncology Physician
  • Coldwater, MI
  • NPI 1215964192
  NPD
• Community Health Center of Branch County

  • Internal Medicine Physician
  • Coldwater, MI
  • NPI 1306873286
  NPD
• Community Health Center of Branch County

  • Pediatric Adolescent Medicine Physician
  • Coldwater, MI
  • NPI 1619304458
  NPD
• Regio T Penna MD, PC

  • Specialist
  • Coldwater, MI
  • NPI 1245213537
  NPD

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

• University Health Shreveport LLC

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1427536325
  Care Compare affiliation
• Iom Health System LP

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335
  Care Compare affiliation

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1023424462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-626-0000",
            "fax_number": "318-629-4833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5734 Coventry Ln",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468047141",
            "country_code": "US",
            "telephone_number": "260-436-7875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISENBAKER",
        "first_name": "BENJAMIN",
        "middle_name": "R.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-07",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28217287A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP07907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Wischoff, DDS
• Lauren Wise
• Rodney Wise, M.D.
• Sharetha Wise
• William R. Wise, MD
• Morgan S. Wisenbaker
• Connor Wisniewski-Top, PT, DPT
• Shila Withers
• Witte Family Dentistry, LLC
• Savanna Taelor Witthoeft

• Certified Registered Nurse Anesthetist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Certified Registered Nurse Anesthetist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.