Individual provider Active NPI

Joe Walther

  • Certified Registered Nurse Anesthetist
  • Baton Rouge, LA
National Provider Identifier
1053683987
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
06755 Issued in LA
Practice address
8212 Summa Ave
Baton Rouge, LA 70809-3421
Phone
(225) 769-4403
NPI assigned
Feb 8, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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 06755 LA Primary

Addresses

Primary practice location

8212 Summa Ave
Baton Rouge, LA 70809-3421

Mailing address

8212 Summa Ave
Baton Rouge, LA 70809-3421

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140307001627 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840459210 Reassigns benefits to 2 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
Blue Lake Health Springhill LLCGroup PAC ID 2365830007, 47 clinicians

Practice addresses (Care Compare)

3719 Dauphin St
Mobile, AL 36608-1753
Phone (251) 460-5220

Hospital & facility affiliations

  • Springhill Medical Center Hospital, Mobile, AL, CCN 010144

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
06755LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Physynergy, LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Physynergy, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2016 Accepting new patients
Blue Lake Health Springhill, LLC CurrentSince Nov 1, 2021 Accepting new patients
Anesthesiology Group Associates Inc Past Accepting new patients

Locations

1 Hospital Dr SW
Huntsville, AL 35801
Phone (256) 429-4000

460 Lanier Rd
Madison, AL 35758
Phone (205) 558-3200

3719 Dauphin St
Mobile, AL 36608
Phone (251) 342-3000

Organizations & group practices 4

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": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1053683987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8212 SUMMA AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8212 SUMMA AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093421",
            "telephone_number": "225-769-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTHER",
        "first_name": "JOE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "06755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

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