Individual provider Active NPI

Courtney N Goudeau, CRNA

  • Certified Registered Nurse Anesthetist
  • Alexandria, LA
National Provider Identifier
1104248483
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP07621 Issued in LA
Practice address
651 North Bolton Avenue
Central Louisiana Surgical Hospital
Alexandria, LA 71301
Phone
(318) 443-3511
Fax
(318) 442-1586
NPI assigned
Jan 6, 2014
Last updated
May 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN122387 LA
Certified Registered Nurse Anesthetist 367500000X AP07621 LA Primary

Addresses

Primary practice location

651 North Bolton Avenue
Central Louisiana Surgical Hospital
Alexandria, LA 71301

Mailing address

PO Box 8278
Red River Anesthesia of Alexandria
Alexandria, LA 71306
Phone (318) 484-5280

Other names 1

  • Courtney Ryder Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140317001528 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183855166 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Louisiana Anesthesia Consultants, ApmcGroup PAC ID 3971408733, 53 clinicians
Youngs Professional Services LLCGroup PAC ID 2163524992, 297 clinicians

Practice addresses (Care Compare)

1444 Peterman Dr
Alexandria, LA 71301-3432
Phone (318) 442-5399

651 N Bolton Ave
Alexandria, LA 71301-7449
Phone (318) 443-3511

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN122387LAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Louisiana Anesthesia Consultants, Apmc CurrentSince Feb 3, 2014 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 17, 2020 Accepting new patients

Locations

1444 Peterman Dr
Alexandria, LA 71301
Phone (318) 442-5399

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

3330 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6917

3436 Masonic Dr
Alexandria, LA 71301
Phone (318) 427-6500

651 N Bolton Ave
Alexandria, LA 71301
Phone (318) 443-3511

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1388966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1104248483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8278",
            "address_2": "RED RIVER ANESTHESIA OF ALEXANDRIA",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "71306",
            "telephone_number": "318-484-5280",
            "fax_number": "318-442-3134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 NORTH BOLTON AVENUE",
            "address_2": "CENTRAL LOUISIANA SURGICAL HOSPITAL",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "71301",
            "telephone_number": "318-443-3511",
            "fax_number": "318-442-1586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUDEAU",
        "first_name": "COURTNEY",
        "middle_name": "N",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-06",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN122387",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP07621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "RYDER",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; 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.