Shelly Broussard Gilbert, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN071326 Issued in LA

Practice address

1757 Imperial Blvd.
Lake Charles, LA 70605

Phone

(337) 310-2832

NPI assigned

Feb 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Doctor of Medicine

State licenses

Practice roles

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.

• DRS Burleigh, Dupleix and Rees

  • Anesthesiology Physician
  • Lafayette, LA
  • NPI 1659368694
  NPD (past)
• Louisiana Anesthesiology Group, L.L.C.

  • Anesthesiology Physician
  • Baton Rouge, LA
  • NPI 1902957103
  NPD (past)
• Surgical Anesthesia Services of California

  • Anesthesiology Physician
  • Davis, CA
  • NPI 1588831531
  NPD (past)

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1154469534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13523 BARRETT PARKWAY DRIVE",
            "address_2": "SUITE 104",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630213802",
            "telephone_number": "636-938-6868",
            "fax_number": "636-938-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1757 IMPERIAL BLVD.",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70605",
            "telephone_number": "337-310-2832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "SHELLY",
        "middle_name": "BROUSSARD",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN071326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SERVICES PART B",
            "identifier": "4B584",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Geriatric Resources, Inc
• Roxanne Germany-Moss, RN,C
• Hannah Lejeune Gettys, MSW, LMSW
• Rachel Gibbs
• James Joseph Gibson, P.D.
• Lukas Gilevicius, DDS
• Amber Gill, PHARMD
• Kayla Gill
• Rebecca Mia Gill
• Emily Shannon Gillard, FNP-C

• Certified Registered Nurse Anesthetist in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Certified Registered Nurse Anesthetist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.