NPIMap

Organization Active NPI

Primary Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • Jennings, LA
National Provider Identifier
1316078595
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
38458 Issued in LA
Legal business name
PRIMARY ANESTHESIA SERVICES
Practice address
1634 Elton Rd
Jennings, LA 70546-3614
Phone
(337) 616-7150
Fax
(337) 616-7164
NPI assigned
Mar 8, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
W. Dean Fontenot
Title
Crna
Phone
(337) 616-7150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X 38458 LA Primary

Addresses

Primary practice location

1634 Elton Rd
Jennings, LA 70546-3614

Mailing address

1634 Elton Rd
Jennings, LA 70546-3614
Phone (337) 616-7150

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316078595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 ELTON RD",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463614",
            "telephone_number": "337-616-7150",
            "fax_number": "337-616-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 ELTON RD",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463614",
            "telephone_number": "337-616-7150",
            "fax_number": "337-616-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY ANESTHESIA SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FONTENOT",
        "authorized_official_first_name": "W.",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "CRNA",
        "authorized_official_telephone_number": "337-616-7150"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "38458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jennings, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.