NPIMap

Organization Active NPI

Tandem Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
National Provider Identifier
1356453583
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
TANDEM ANESTHESIA LLC
Practice address
445 Ashley Ridge Blvd
Shreveport, LA 71106-7229
Phone
(847) 615-2200
Fax
(847) 615-2858
NPI assigned
Sep 1, 2006
Last updated
Jun 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Sean Hintz, CRNANPI 1508926510
Title
President
Phone
(847) 615-2200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

445 Ashley Ridge Blvd
Shreveport, LA 71106-7229

Mailing address

PO Box 757
Benton, LA 71006-0757
Phone (847) 615-2200

Other identifiers 2

IdentifierTypeStateIssuer
1449512MedicaidLA
721479750OtherLABCBS OF LOUISIANA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040107000123 LA Part B Supplier - Clinic/Group Practice 0446159685 Receives reassigned benefits from 24 practitioners
Practice locations: Mansfield, LA; Natchitoches, LA; Shreveport, LA; Coushatta, LA

National Provider Directory

National Provider Directory

Locations

1455 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 300-3643

457 Ashley Ridge Blvd
Shreveport, LA 71106
Phone (318) 861-1260

7941 Youree Dr
Shreveport, LA 71105
Phone (318) 797-7941

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1356453583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 757",
            "city": "BENTON",
            "state": "LA",
            "postal_code": "710060757",
            "telephone_number": "847-615-2200",
            "fax_number": "847-615-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 ASHLEY RIDGE BLVD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067229",
            "telephone_number": "847-615-2200",
            "fax_number": "847-615-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANDEM ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "HINTZ",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-615-2200",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1449512",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF LOUISIANA",
            "identifier": "721479750",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.