Individual provider Active NPI

Amy W. Landry, CRNA

  • Certified Registered Nurse Anesthetist
  • Lafayette, LA
National Provider Identifier
1326023672
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP01528 Issued in LA
Practice address
1103 Kaliste Saloom Rd
Suite 304
Lafayette, LA 70508-5783
Phone
(337) 988-5646
Fax
(337) 988-4298
NPI assigned
Dec 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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 AP01528 LA Primary

Addresses

Primary practice location

1103 Kaliste Saloom Rd
Suite 304
Lafayette, LA 70508-5783

Mailing address

1103 Kaliste Saloom Rd
Suite 304
Lafayette, LA 70508-5783
Phone (337) 988-5646

Other identifiers 1

IdentifierTypeStateIssuer
1981788MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1326023672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 KALISTE SALOOM RD",
            "address_2": "SUITE 304",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085783",
            "telephone_number": "337-988-5646",
            "fax_number": "337-988-4298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 KALISTE SALOOM RD",
            "address_2": "SUITE 304",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085783",
            "telephone_number": "337-988-5646",
            "fax_number": "337-988-4298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "AMY",
        "middle_name": "W.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-09",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP01528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1981788",
            "state": "LA"
        }
    ],
    "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 Aug 2, 2010; 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.