Individual provider Active NPI

Kelley Goodman Frankowicz, CRNA

  • Certified Registered Nurse Anesthetist
  • Monroe, LA
National Provider Identifier
1063717460
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
883932 Issued in MS
Practice address
312 Grammont St
Suite 101
Monroe, LA 71201-7457
Phone
(318) 998-6129
NPI assigned
Jan 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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 883932 MS Primary

Addresses

Primary practice location

312 Grammont St
Suite 101
Monroe, LA 71201-7457

Mailing address

PO Box 3185
Monroe, LA 71210-3185
Phone (318) 998-6129

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120223000647 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789866294 Reassigns benefits to 2 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
Smso Anesthesia, LLCGroup PAC ID 7012970627, 49 clinicians

Practice addresses (Care Compare)

2408 Broadmoor Blvd
Monroe, LA 71201-2994
Phone (318) 812-1760

309 Jackson St
Monroe, LA 71201-7407
Phone (318) 812-1760

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
883932MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Brfhh Monroe LLC CurrentSince Nov 9, 2020 Accepting new patients
Brfhh Monroe LLC CurrentSince Nov 9, 2020 Accepting new patients
Endoscopy Center of Monroe Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

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": "1294963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1063717460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3185",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712103185",
            "telephone_number": "318-998-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 GRAMMONT ST",
            "address_2": "SUITE 101",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017457",
            "telephone_number": "318-998-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANKOWICZ",
        "first_name": "KELLEY",
        "middle_name": "GOODMAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-14",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "883932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; 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.