Richard Nathan Disotell, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APO6740 Issued in LA

Practice address

1501 Kings Hwy
Shreveport, LA 71103-4228

Phone

(318) 675-5584

Fax

(318) 675-6681

NPI assigned

Feb 1, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Health Shreveport, LLCGroup PAC ID 7416207196, 64 clinicians

Practice addresses (Care Compare)

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.

• University Health Shreveport LLC

  • Nurse Practitioner
  • Shreveport, LA
  • NPI 1619443611
  Medicare reassignment Care Compare group NPD
• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222
  Medicare reassignment NPD

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1235401696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-5584",
            "fax_number": "318-675-6681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-5584",
            "fax_number": "318-675-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISOTELL",
        "first_name": "RICHARD",
        "middle_name": "NATHAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-01",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "APO6740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Carole Dipoto Brahmbhatt, MD
• Discount Medical Supply, Inc.
• Discovery Counseling Services
• Discrete Enterprises
• Meagan Marie Disotell, NP
• Divine Beauty Supply Inc
• Divine Behavioral Health, LLC
• Divine Case Management LLC
• Divine Case Management,LLC
• Divine Case Management,LLC

• Certified Registered Nurse Anesthetist in Shreveport, LA
• Providers in Shreveport, 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 Feb 1, 2012; 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.