Individual provider Active NPI

Robert Geise Phillips, CRNA

  • Certified Registered Nurse Anesthetist
  • Lake Charles, LA
National Provider Identifier
1063554814
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
36863 Issued in LA
Practice address
4150 Nelson Rd
A4 Anesthesia Associates
Lake Charles, LA 70605
Phone
(337) 474-6353
Fax
(337) 477-7616
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 36863 LA Primary

Addresses

Primary practice location

4150 Nelson Rd
A4 Anesthesia Associates
Lake Charles, LA 70605

Mailing address

4150 Nelson Rd
A4 Anesthesia Associates
Lake Charles, LA 70605
Phone (337) 474-6353

Other identifiers 1

IdentifierTypeStateIssuer
1390909MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110103000854 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042408205 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36863LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Charles Anesthesiology, Apmc CurrentSince Aug 1, 2023 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 11, 2023 Accepting new patients

Locations

1757 Imperial Blvd
Lake Charles, LA 70605
Phone (337) 310-2832

524 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 430-4455

4150 Nelson Rd
Ste 4
Lake Charles, LA 70605
Phone (318) 474-6353

4150 Nelson Rd
Ste A4
Lake Charles, LA 70605
Phone (318) 474-6353

501 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 312-8258

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

701 Cypress St
Sulphur, LA 70663
Phone (337) 527-4270

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063554814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 NELSON RD",
            "address_2": "A4 ANESTHESIA ASSOCIATES",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70605",
            "telephone_number": "337-474-6353",
            "fax_number": "337-477-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 NELSON RD",
            "address_2": "A4 ANESTHESIA ASSOCIATES",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70605",
            "telephone_number": "337-474-6353",
            "fax_number": "337-477-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "ROBERT",
        "middle_name": "GEISE",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "36863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1390909",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.