Individual provider Active NPI

Brian K Thomas

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
National Provider Identifier
1104654250
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
201131 Issued in LA
Practice address
542 Mockingbird LN
Shreveport, LA 71105-4322
Phone
(318) 840-2209
NPI assigned
Jul 22, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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 201131 LA Primary
Critical Care Medicine Registered Nurse 163WC0200X 201131 LA

Addresses

Primary practice location

542 Mockingbird LN
Shreveport, LA 71105-4322

Mailing address

542 Mockingbird LN
Shreveport, LA 71105-4322
Phone (318) 840-2209

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260312001120 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769965201 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novus Louisiana Medical Professional CorporationGroup PAC ID 5395194880, 23 clinicians
University Health Shreveport, LLCGroup PAC ID 7416207196, 64 clinicians

Practice addresses (Care Compare)

1500 Line Ave
Suite 206
Shreveport, LA 71101-4649
Phone (318) 213-3800

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 626-0000

Hospital & facility affiliations

  • Specialists Hospital Shreveport Hospital, Shreveport, LA, CCN 190278
  • Ochsner Lsu Health Shreveport Hospital, Shreveport, LA, CCN 190098

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
201131LAMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Novus Louisiana Medical Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince Feb 3, 2026 Accepting new patients
University Health Shreveport LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 2, 2026 Accepting new patients
University Health Shreveport LLC CurrentSince Mar 2, 2026 Accepting new patients

Locations

911 Margaret Pl
Shreveport, LA 71101
Phone (318) 626-4200

1500 Line Ave
Ste 206
Shreveport, LA 71101
Phone (318) 213-3800

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

Organizations & group practices 3

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": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1104654250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 MOCKINGBIRD LN",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054322",
            "telephone_number": "318-840-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 MOCKINGBIRD LN",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054322",
            "telephone_number": "318-840-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "BRIAN",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-22",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "201131",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "LA",
            "license": "201131",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; 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.