Individual provider Active NPI

Amy Louise Breckenridge, CRNA

  • Certified Registered Nurse Anesthetist
  • Houma, LA
National Provider Identifier
1326202136
Registry record updated Mar 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
05526 Issued in LA
Practice address
1978 Industrial Blvd
Anesthesia Dept.
Houma, LA 70363-7055
Phone
(985) 873-1814
NPI assigned
Jul 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2019

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 05526 LA Primary

Addresses

Primary practice location

1978 Industrial Blvd
Anesthesia Dept.
Houma, LA 70363-7055

Mailing address

1978 Industrial Blvd
Anesthesia Dept.
Houma, LA 70363-7055
Phone (985) 873-1814

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080813000102 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254406127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Louisiana Medical AssociatesGroup PAC ID 8527968650, 112 clinicians

Practice addresses (Care Compare)

1990 Industrial Blvd
Houma, LA 70363-7055
Phone (985) 868-9300

1990 Industrial Boulevard
Houma, LA 70363-7055

Hospital & facility affiliations

  • Leonard J Chabert Medical Center Hospital, Houma, LA, CCN 190183

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05526LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
South Louisiana Medical Associates Nurse Anesthetist, Certified Registered CurrentSince Jun 24, 2013 Accepting new patients
South Louisiana Medical Associates CurrentSince Jun 24, 2013 Accepting new patients

Locations

1990 Industrial Blvd
Houma, LA 70363
Phone (985) 868-9300

1978 Industrial Blvd
Houma, LA 70363
Phone (985) 873-1814

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 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": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1326202136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1978 INDUSTRIAL BLVD",
            "address_2": "ANESTHESIA DEPT.",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703637055",
            "telephone_number": "985-873-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1978 INDUSTRIAL BLVD",
            "address_2": "ANESTHESIA DEPT.",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703637055",
            "telephone_number": "985-873-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRECKENRIDGE",
        "first_name": "AMY",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-11",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "05526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; 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.