Theresa Bourg Vicknair, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP01519 Issued in LA

Practice address

St James Parish Hosipital
Louisiane Ave
Lutcher, LA 70071

Phone

(225) 869-5512

NPI assigned

Nov 10, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Zephyr Anesthesia, LLC

  • Anesthesiology Physician
  • La Place, LA
  • NPI 1891087458

  LA

  Medicare reassignment Care Compare group
• Childrens Hospital Anesthesia Corporation

  • Anesthesiology Physician
  • New Orleans, LA
  • NPI 1649362740

  LA

  Medicare reassignment NPD
• Firas Hijazi MD Apmc

  • Interventional Pain Medicine Physician
  • La Place, LA
  • NPI 1740495829
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. James Parish Hosp. Serv. Dist.

  • Critical Access Hospital
  • Lutcher, LA
  • NPI 1588654966

  Hospital

  Care Compare affiliation

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Zephyr Anesthesia LLC 161 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St James Parish Hospital Hospital, Lutcher, LA, CCN 191305

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1134100746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 JENNIFER LN",
            "city": "LA PLACE",
            "state": "LA",
            "postal_code": "700685806",
            "telephone_number": "985-359-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST JAMES PARISH HOSIPITAL",
            "address_2": "LOUISIANE AVE",
            "city": "LUTCHER",
            "state": "LA",
            "postal_code": "70071",
            "telephone_number": "225-869-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKNAIR",
        "first_name": "THERESA",
        "middle_name": "BOURG",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN059871",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP01519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Thomas
• Turner Medical Clinic
• Katherine Vaughn-Harden, CCC-SLP
• Rachell Velasco, DMD
• Glenda Poche Vicknair, CRNA
• Quang Duy Vu, DDS
• Brittany Walker, OT
• Steve Ray Warren Jr.
• Jaonte Washington
• Dustin Michael Weidert, OD

• All providers in Lutcher, LA
• Certified Registered Nurse Anesthetist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.