Individual provider Active NPI

Jeffrey Lewis Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • Lafayette, LA
National Provider Identifier
1245269620
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN096852 Issued in LA
Practice address
1214 Coolidge Blvd
Lafayette, LA 70503-2621
Phone
(504) 779-5515
NPI assigned
Jun 30, 2006
Last updated
Sep 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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 RN096852 LA Primary

Addresses

Primary practice location

1214 Coolidge Blvd
Lafayette, LA 70503-2621

Mailing address

744 W Michigan Ave
Jackson, MI 49201-1909
Phone (517) 787-6440

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060303000535 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3274549910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lafayette Health Ventures IncGroup PAC ID 9335043074, 299 clinicians

Practice addresses (Care Compare)

1214 Coolidge Blvd
Lafayette, LA 70503-2621
Phone (337) 289-7991

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lafayette Health Ventures Inc CurrentSince Apr 1, 2021 Accepting new patients
Lafayette Health Ventures Inc Current Accepting new patients
Lafayette Health Ventures Inc. CurrentSince Apr 1, 2021 Accepting new patients
Lafayette Health Ventures, Inc Past Accepting new patients
Parish Anesthesia Endoscopy of Lafayette, LLC Past Accepting new patients
DRS Burleigh, Dupleix and Rees Past Accepting new patients

Locations

210 Champagne Blvd
Breaux Bridge, LA 70517
Phone (337) 332-2178

1305 E Highway 90
Crowley, LA 70526
Phone (337) 783-3222

1000 W Pinhook Rd
Lafayette, LA 70503
Phone (337) 289-7311

1000 W Pinhook Rd
Ste 305
Lafayette, LA 70503
Phone (337) 235-1600

1214 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 234-9191

2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000

2810 Ambassador Caffery Pkwy
Lafayette, LA 70506
Phone (337) 593-5423

4212 W Congress St
Ste 3100
Lafayette, LA 70506
Phone (337) 703-3201

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1245269620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011909",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 COOLIDGE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032621",
            "telephone_number": "504-779-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEFFREY",
        "middle_name": "LEWIS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN096852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.