Individual provider Active NPI

Kendal W Miller, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Sam Houston, TX
National Provider Identifier
1053625426
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP06178 Issued in LA
Practice address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone
(210) 916-9588
NPI assigned
Jul 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP06178 LA Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Mailing address

1090 Arnold Dr
Little Rock Afb, AR 72099-4933
Phone (501) 987-7445

Other identifiers 2

IdentifierTypeStateIssuer
2125630MedicaidLA
1053625426OtherLABCBS OF LA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101029000067 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082808530 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lafayette Health Ventures IncGroup PAC ID 9335043074, 299 clinicians

Practice addresses (Care Compare)

1214 Coolidge Blvd
Lafayette, LA 70503-2621
Phone (337) 289-7991

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Zephyr Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 20, 2012 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 15, 2011 Accepting new patients
Galleria Anesthesia Associates, LLC CurrentSince Jul 18, 2025 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G Current Accepting new patients
Lafayette Health Ventures, Inc CurrentSince Aug 1, 2025 Accepting new patients
Lafayette Health Ventures Inc CurrentSince Aug 1, 2025 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Oct 22, 2023 Accepting new patients
Lafayette Health Ventures Inc Current Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Oct 22, 2023 Accepting new patients
Northlake Anesthesiologists, a Professional Corporation CurrentSince Aug 1, 2015 Accepting new patients

Locations

131 Cherokee Rose Ln
Ste A
Covington, LA 70433
Phone (985) 809-8068

67252 Industry Ln
Covington, LA 70433
Phone (985) 801-0259

694 Belle Terre Blvd
La Place, LA 70068
Phone (985) 359-6694

4212 W Congress St
Ste 3100
Lafayette, LA 70506
Phone (337) 703-3201

1214 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 234-9191

1100 Andre St
Ste 300
New Iberia, LA 70563
Phone (337) 364-9225

2000 Canal St
New Orleans, LA 70112
Phone (504) 702-2287

2021 Perdido St
New Orleans, LA 70112
Phone (504) 412-1800

1717 Saint Charles Ave
New Orleans, LA 70130
Phone (504) 529-6600

2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741

1542 Tulane Ave
New Orleans, LA 70112
Phone (504) 866-2741

1700 Lindberg Dr
Slidell, LA 70458
Phone (800) 598-7291

Organizations & group practices 11

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": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1053625426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 ARNOLD DR",
            "city": "LITTLE ROCK AFB",
            "state": "AR",
            "postal_code": "720994933",
            "telephone_number": "501-987-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KENDAL",
        "middle_name": "W",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-28",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP06178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2125630",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF LA",
            "identifier": "1053625426",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.