Individual provider Active NPI

Gavin Nathan Baker, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, MI
National Provider Identifier
1063709335
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP06485 Issued in LA
Practice address
255 W Michigan Ave
Jackson, MI 49201-2218
Phone
(800) 516-5315
Fax
(517) 787-7365
NPI assigned
Jul 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN117613 LA
Certified Registered Nurse Anesthetist 367500000X AP06485 LA Primary

Addresses

Primary practice location

255 W Michigan Ave
Jackson, MI 49201-2218

Mailing address

3510 N Causeway Blvd
Suite 404
Metairie, LA 70002-3531
Phone (504) 779-5515

Other practice location 1

1001 Gause Blvd
Slidell, LA 70458-2939
Phone (985) 280-2200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110817000359 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133398639 Reassigns benefits to 6 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
Zephyr Anesthesia LLCGroup PAC ID 1658559125, 161 clinicians

Practice addresses (Care Compare)

694 Belle Terre Blvd
La Place, LA 70068-1620
Phone (985) 359-6694

8000 W Judge Perez Dr
Chalmette, LA 70043-1668
Phone (504) 309-5601

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN117613LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Center Management Corporation CurrentSince Mar 1, 2015 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Jul 1, 2023 Accepting new patients
Zephyr Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince May 11, 2012 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Jul 1, 2023 Accepting new patients
Ochsner Clinic LLC CurrentSince Dec 31, 2022 Accepting new patients
University Medical Center Management Corporation CurrentSince Mar 1, 2015 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Aec Physicians, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2018 Accepting new patients
Childrens Hospital Anesthesia Corporation CurrentSince Mar 1, 2017 Accepting new patients
Ochsner Clinic LLC CurrentSince Dec 31, 2022 Accepting new patients

Locations (25 of 35)

323 W Walnut Ave
Bastrop, LA 71220
Phone (318) 283-3600

8000 W Judge Perez Dr
Chalmette, LA 70043
Phone (504) 493-6078

1234 Pinnacle Pkwy
Covington, LA 70433
Phone (985) 200-1213

4407 Highway 190 East Service Rd
Ste 200
Covington, LA 70433
Phone (985) 234-9700

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

191 Innovation Ct
Ste A
Gray, LA 70359
Phone (985) 303-4050

42107 Veterans Ave
Hammond, LA 70403
Phone (504) 419-1884

3704 Lapalco Blvd
Harvey, LA 70058
Phone (504) 207-5320

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

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

1645 Lutcher Ave
Lutcher, LA 70071
Phone (225) 258-5901

1111 Medical Center Blvd
Marrero, LA 70072
Phone (504) 349-2332

1101 Medical Center Blvd
Marrero, LA 70072
Phone (504) 347-5511

3717 Houma Blvd
Ste 200
Metairie, LA 70006
Phone (504) 885-7676

2520 Harvard Ave
Ste 2A
Metairie, LA 70001
Phone (504) 378-3668

4324 Veterans Memorial Blvd
Ste 102
Metairie, LA 70006

3510 N Causeway Blvd
Ste 404
Metairie, LA 70002
Phone 5047795515 ext. 216

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

720 Veterans Memorial Blvd
Ste 100
Metairie, LA 70005
Phone (504) 293-4955

3717 Houma Blvd
Ste 300
Metairie, LA 70006
Phone (504) 456-1515

4700 S I 10 Svc Rd W
Metairie, LA 70001
Phone (504) 780-6453

3434 Houma Blvd
Ste 300
Metairie, LA 70006
Phone (504) 454-2017

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

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

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

Organizations & group practices 10

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": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1063709335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 N CAUSEWAY BLVD",
            "address_2": "SUITE 404",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700023531",
            "telephone_number": "504-779-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "800-516-5315",
            "fax_number": "517-787-7365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Gause Blvd",
            "address_purpose": "LOCATION",
            "city": "Slidell",
            "state": "LA",
            "postal_code": "704582939",
            "country_code": "US",
            "telephone_number": "985-280-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKER",
        "first_name": "GAVIN",
        "middle_name": "NATHAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN117613",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP06485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; 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.