Individual provider Active NPI

Michael Kent Vickers, CRNA

  • Certified Registered Nurse Anesthetist
  • Metairie, LA
National Provider Identifier
1205018181
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN106549 Issued in LA
Practice address
3510 N Causeway Blvd
Suite 404
Metairie, LA 70002-3531
Phone
(504) 779-5515
NPI assigned
Dec 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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 RN106549 LA Primary

Addresses

Primary practice location

3510 N Causeway Blvd
Suite 404
Metairie, LA 70002-3531

Mailing address

9853 Jefferson Hwy
Unit #F-6
Baton Rouge, LA 70809-2794

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080611000000 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557432044 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Capital City Anesthesia Group, LLCGroup PAC ID 1658272844, 49 clinicians

Practice addresses (Care Compare)

8585 Picardy Ave
Baton Rouge, LA 70809-3748
Phone (225) 763-4000

Hospital & facility affiliations

  • Baton Rouge General Medical Center Hospital, Baton Rouge, LA, CCN 190065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN106549LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
The Capital City Anesthesia Group, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 17, 2008 Accepting new patients
Anesthesiology Group Associates Inc CurrentSince Jul 9, 2015 Accepting new patients

Locations

7777 Hennessy Blvd
Ste 301
Baton Rouge, LA 70808
Phone (225) 214-6436

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

9032 Perkins Rd
Baton Rouge, LA 70810
Phone (225) 358-4853

11414 Lake Sherwood Ave N
Baton Rouge, LA 70816
Phone (225) 532-4058

3600 Florida St
Baton Rouge, LA 70806
Phone (225) 381-2615

3510 N Causeway Blvd
Ste 404
Metairie, LA 70002
Phone 5047795515 ext. 216

Organizations & group practices 2

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 6

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": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1205018181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9853 JEFFERSON HWY",
            "address_2": "UNIT #F-6",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708092794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 N CAUSEWAY BLVD",
            "address_2": "SUITE 404",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700023531",
            "telephone_number": "504-779-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "MICHAEL",
        "middle_name": "KENT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-03",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN106549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.