Active NPI
Mary Stroud, CRNA
- Certified Registered Nurse Anesthetist
- Slidell, LA
National Provider Identifier
1104892793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN045603
- Practice address
- 1001 Gause Blvd
Slidell, LA 70458-2939 - Phone
- (985) 649-8767
- NPI assigned
- Feb 24, 2006
- Sex
- Female
- 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 | RN045603 | LA | Primary |
Addresses
Primary practice location
1001 Gause Blvd
Slidell, LA 70458-2939
Mailing address
120 Innwood Dr
Covington, LA 70433-9123
Phone (985) 892-3225
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1907219 | Medicaid | LA |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN045603 | LA | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197072000000",
"number": "1104892793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 INNWOOD DR",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704339123",
"telephone_number": "985-892-3225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 GAUSE BLVD",
"city": "SLIDELL",
"state": "LA",
"postal_code": "704582939",
"telephone_number": "985-649-8767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STROUD",
"first_name": "MARY",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-24",
"last_updated": "2007-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "LA",
"license": "RN045603",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1907219",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Slidell, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.