Active NPI
Gerald J Luchtefeld, CRNA
- Certified Registered Nurse Anesthetist
- Saint Louis, MO
National Provider Identifier
1093891228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 077785
- Practice address
- 3933 S Broadway
Saint Louis, MO 63118 - Phone
- (314) 268-6144
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 077785 | MO | Primary |
Addresses
Primary practice location
3933 S Broadway
Saint Louis, MO 63118
Mailing address
940 West Port Plaza
Ste 270
Saint Louis, MO 63146
Phone (314) 453-0600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 077785 | MO | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093891228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "940 WEST PORT PLAZA",
"address_2": "STE 270",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "63146",
"telephone_number": "314-453-0600",
"fax_number": "314-453-0083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3933 S BROADWAY",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "63118",
"telephone_number": "314-268-6144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCHTEFELD",
"first_name": "GERALD",
"middle_name": "J",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "077785",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.