Individual provider Active NPI

Nicole Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • New Orleans, LA
National Provider Identifier
1174946503
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN132278 Issued in LA
Practice address
1401 Foucher St
New Orleans, LA 70115-3515
Phone
(504) 897-8300
NPI assigned
Jan 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN132278 LA Primary

Addresses

Primary practice location

1401 Foucher St
New Orleans, LA 70115-3515

Mailing address

255 W Michigan Ave
P O Box 1123
Jackson, MI 49201-2218
Phone (800) 516-5315

Other names 1

  • Nicole H Martin Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180314002315 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860612280 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
Metropolitan Anesthesia Consultants, LLPGroup PAC ID 3971516642, 137 clinicians

Practice addresses (Care Compare)

3300 Oak Lawn Ave
Suite 200
Dallas, TX 75219-4265
Phone (214) 252-3501

Hospital & facility affiliations

  • Medical Center of McKinney Hospital, McKinney, TX, CCN 450403

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN132278LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Anesthesia Consultants, LLP CurrentSince Dec 1, 2021 Accepting new patients
Pediatric Dentistry of Keller PLLC PastSince Jul 28, 2019 Accepting new patients

Locations

3301 Matlock Rd
Arlington, TX 76015
Phone (682) 509-6200

3502 Corinth Pkwy
Ste 120
Corinth, TX 76208
Phone (940) 765-8403

3625 N Hall St
Ste 800
Dallas, TX 75219
Phone (214) 252-3500

9440 Poppy Dr
Dallas, TX 75218
Phone (214) 324-6100

3300 Oak Lawn Ave
Ste 200
Dallas, TX 75219
Phone (214) 252-3500

12505 Lebanon Rd
Frisco, TX 75035
Phone (972) 731-4800

4500 Medical Center Dr
McKinney, TX 75069
Phone (972) 547-8190

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

3150 Horizon Rd
Rockwall, TX 75032
Phone (469) 697-1000

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 1

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": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1174946503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "address_2": "P O BOX 1123",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "800-516-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 FOUCHER ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701153515",
            "telephone_number": "504-897-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICOLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-21",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN132278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MARTIN",
            "middle_name": "H",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; 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.