Individual provider Active NPI

Marlo C Martin, CRNA

  • Certified Registered Nurse Anesthetist
  • Baton Rouge, LA
National Provider Identifier
1336463355
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN114386 AP06025 Issued in MA
Practice address
100 Womans Way
Baton Rouge, LA 70817-5100
Phone
(225) 293-2523
Fax
(225) 293-1807
NPI assigned
Mar 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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 RN114386 AP06025 MA Primary

Addresses

Primary practice location

100 Womans Way
Baton Rouge, LA 70817-5100

Mailing address

2644 S Sherwood Forest Blvd
Suite 121
Baton Rouge, LA 70816-2248
Phone (225) 293-2523

Other identifiers 1

IdentifierTypeStateIssuer
RN114386 AP06025OtherLALA LIC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100719000852 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052443538 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louisiana Anesthesiology Group L.L.C.Group PAC ID 6507758505, 36 clinicians
Anesthesiology Affiliates LLCGroup PAC ID 6800936162, 39 clinicians

Practice addresses (Care Compare)

100 Womans Way
Baton Rouge, LA 70817-5100
Phone (225) 468-6070

9103 Jefferson Hwy
Baton Rouge, LA 70809-2440
Phone (225) 927-1190

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN114386 AP06025MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Group Associates Inc CurrentSince Dec 4, 2020 Accepting new patients
Dpi of Louisiana LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2025 Accepting new patients
Anesthesiology Affiliates, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 18, 2025 Accepting new patients
Diversified Professionals, Inc. CurrentSince Jun 26, 2023 Accepting new patients
St. Tammany Pathology Past Accepting new patients

Locations

7777 Hennessy Blvd
Ste 301
Baton Rouge, LA 70808
Phone (225) 214-6436

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

9032 Perkins Rd
Baton Rouge, LA 70810
Phone (225) 358-4853

7145 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 765-3111

7301 Hennessy Blvd
#100
Baton Rouge, LA 70808
Phone (225) 215-3443

9103 Jefferson Hwy
Baton Rouge, LA 70809
Phone (225) 927-1190

17000 Medical Center Dr
Baton Rouge, LA 70816
Phone (225) 752-2470

8946 Interline Ave
Ste C
Baton Rouge, LA 70809
Phone (225) 529-1143

11414 Lake Sherwood Ave N
Baton Rouge, LA 70816
Phone (225) 532-4058

6550 Main St
Ste 2600
Zachary, LA 70791
Phone (225) 570-6357

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1336463355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2644 S SHERWOOD FOREST BLVD",
            "address_2": "SUITE 121",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708162248",
            "telephone_number": "225-293-2523",
            "fax_number": "225-293-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOMANS WAY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708175100",
            "telephone_number": "225-293-2523",
            "fax_number": "225-293-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MARLO",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-19",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN114386 AP06025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA LIC",
            "identifier": "RN114386 AP06025",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.