Individual provider Active NPI

Julia Marie Labossiere, CRNA

  • Certified Registered Nurse Anesthetist
  • Providence, RI
National Provider Identifier
1144664400
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN00192 Issued in RI
Practice address
593 Eddy St
Davol 129
Providence, RI 02903-4923
Phone
(401) 444-4933
Fax
(401) 444-5090
NPI assigned
Apr 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN49383 RI
Certified Registered Nurse Anesthetist 367500000X RNA36754 RI
Certified Registered Nurse Anesthetist 367500000X APRN00192 RI Primary

Addresses

Primary practice location

593 Eddy St
Davol 129
Providence, RI 02903-4923

Mailing address

One Virginia Avenue
Suite 201
Providence, RI 02905
Phone (401) 490-0916

Other practice location 1

33 Staniford St
Providence, RI 02905-3105
Phone (401) 421-8800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130911000700 RI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012151152 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
University Gastroenterology, LLCGroup PAC ID 3678762804, 99 clinicians

Practice addresses (Care Compare)

33 Staniford St
Providence, RI 02905-3105
Phone (401) 421-8800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN00192RIMDCertified Registered Nurse Anesthetist
RN49383RIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University Gastroenterology, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2020 Accepting new patients
Narragansett Bay Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince May 8, 2023 Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

1407 S County Trl
Ste 410
East Greenwich, RI 02818
Phone (401) 886-4040

110 Clock Tower Sq
Ste 100
Portsmouth, RI 02871
Phone (401) 293-5600

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

33 Staniford St
Providence, RI 02905
Phone (401) 274-1810

148 W River St
Providence, RI 02904
Phone (401) 421-6306

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

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.

NPI Registry JSON

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1144664400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE VIRGINIA AVENUE",
            "address_2": "SUITE 201",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02905",
            "telephone_number": "401-490-0916",
            "fax_number": "401-490-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "DAVOL 129",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4933",
            "fax_number": "401-444-5090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 Staniford St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029053105",
            "country_code": "US",
            "telephone_number": "401-421-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LABOSSIERE",
        "first_name": "JULIA",
        "middle_name": "MARIE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-17",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "RI",
            "license": "RN49383",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "RI",
            "license": "RNA36754",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "RI",
            "license": "APRN00192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.