Active NPI
Glen Michael Cavalier, CRNA
- Certified Registered Nurse Anesthetist
- Gulfport, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R875676
- Practice address
- 15200 Community Rd
Gulfport, MS 39503-3085 - Phone
- (228) 575-7000
- NPI assigned
- Mar 9, 2006
- Last updated
- Sep 5, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 28162301A | IN | |
| Certified Registered Nurse Anesthetist | 367500000X | R875676 | MS | Primary |
Addresses
Primary practice location
15200 Community Rd
Gulfport, MS 39503-3085
Mailing address
15190 Community Rd
Ste 230a
Gulfport, MS 39503-3483
Phone (228) 831-0204
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
15200 Community Rd
Gulfport, MS 39503-3085
Phone (228) 575-7000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28162301A | IN | MD | Certified Registered Nurse Anesthetist |
| R875676 | MS | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Singing River Gulfport | Current | Accepting new patients | |
| Lifelinc Anesthesia, PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Singing River Gulfport | Current | Accepting new patients | |
| Florida Gulf-to-Bay Anesthesiology Associates, LLC | Past | Accepting new patients | |
| Gulfport Outpatient Anesthesia, P.a. | Past | Accepting new patients |
Locations
634 Leigh Dr
Columbus, MS 39705
Phone (601) 978-3393
15190 Community Rd
Ste 230A
Gulfport, MS 39503
Phone (228) 831-0204
15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000
5001 Hardy St
Hattiesburg, MS 39402
Phone (601) 268-8000
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Singing River Gulfport Anesthesia
- Anesthesiology Physician
- Gulfport, MS
- NPI 1780312504
-
- Anesthesiology Physician
- Memphis, TN
- NPI 1801021464
MS, Nurse Anesthetist, Certified Registered
-
dba Singing River Gulfport Ambulatory
- Multi-Specialty Clinic/Center
- Gulfport, MS
- NPI 1861010159
-
- Anesthesiology Physician
- Gulfport, MS
- NPI 1245402148
-
- Anesthesiology Physician
- Evansville, IN
- NPI 1083665426
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Gulfport, MS
- NPI 1639797913
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567641600000",
"number": "1043288541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15190 COMMUNITY RD",
"address_2": "STE 230A",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395033483",
"telephone_number": "228-831-0204",
"fax_number": "228-831-1868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15200 COMMUNITY RD",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395033085",
"telephone_number": "228-575-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVALIER",
"first_name": "GLEN",
"middle_name": "MICHAEL",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-09",
"last_updated": "2019-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IN",
"license": "28162301A",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MS",
"license": "R875676",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gulfport, MS
- Ellen Dauterive Caswell, MD
- Jason W Caswell, PA
- Catalyst Counseling and Therapy Services LLC
- Catholic Social & Community Services (Catholic Charities of South Mississippi)
- Jack Q Causey II, MD
- Roxanne Cavataio, LCSW
- Isaure Caviness, LMSW
- Richard Joseph Cefalu, LMT 2859
- Faye Centeno, WHCNP
- Center for Diabetes Management, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; 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.