Individual provider Active NPI

Loren B Thiel, MS CRNA

  • Certified Registered Nurse Anesthetist
  • Douglas, WY
National Provider Identifier
1063503514
Registry record updated Feb 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
192490704 Issued in WY
Practice address
111 S 5TH St
Douglas, WY 82633-2434
Phone
(307) 358-2122
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2018

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 192490704 WY Primary

Addresses

Primary practice location

111 S 5TH St
Douglas, WY 82633-2434

Mailing address

PO Box 1385
Idaho Falls, ID 83403-1385
Phone (208) 525-2090

Other identifiers 3

IdentifierTypeStateIssuer
311834OtherWYBCBS
114342500MedicaidWY
P00065251OtherRAILROAD MC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041108000211 WY Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042205718 Reassigns benefits to 2 organizations
Practice locations: Casper, WY

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

111 S 5TH St
Douglas, WY 82633-2434
Phone (307) 358-2122

6350 E 2ND St
Casper, WY 82609-4264
Phone (307) 232-6600

700 E Ctr St
Douglas, WY 82633-2446
Phone (307) 358-7300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Science

State licenses

LicenseStateTypeSpecialty
192490704WYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of Converse County CurrentSince Jan 1, 2014 Accepting new patients
Panhandle Anesthesia Associates PC Past Accepting new patients
Wyoming Regional Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

111 S 5th St
Douglas, WY 82633
Phone (307) 358-6200

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 2

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518652800000",
    "number": "1063503514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1385",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834031385",
            "telephone_number": "208-525-2090",
            "fax_number": "208-523-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 5TH ST",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826332434",
            "telephone_number": "307-358-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEL",
        "first_name": "LOREN",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "MS CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2018-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WY",
            "license": "192490704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "311834",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114342500",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MC",
            "identifier": "P00065251",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2018; 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.