Individual provider Active NPI

Lindsay Reynolds, CRNA

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
National Provider Identifier
1366190068
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
226655 Issued in LA
Practice address
1500 Line Ave
Shreveport, LA 71101-4639
Phone
(318) 213-3800
NPI assigned
Mar 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 143088 LA
Certified Registered Nurse Anesthetist 367500000X 226655 LA Primary

Addresses

Primary practice location

1500 Line Ave
Shreveport, LA 71101-4639

Mailing address

3732 Sabine Pass Dr
Bossier City, LA 71111-6359
Phone (318) 560-4979

Other practice location 1

3732 Sabine Pass Dr
Bossier City, LA 71111-6359
Phone (318) 560-4979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220817001912 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022499813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novus Louisiana Medical Professional CorporationGroup PAC ID 5395194880, 23 clinicians

Practice addresses (Care Compare)

1500 Line Ave
Suite 206
Shreveport, LA 71101-4649
Phone (318) 213-3800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
143088LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Center Anesthesiologists CurrentSince Jul 8, 2022 Accepting new patients
Novus Louisiana Medical Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2023 Accepting new patients

Locations

1500 Line Ave
Shreveport, LA 71101
Phone (318) 213-3754

708 N Ashley Ridge Loop
Ste 400
Shreveport, LA 71106
Phone (318) 210-3315

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

1500 Line Ave
Ste 206
Shreveport, LA 71101
Phone (318) 213-3800

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": "1647129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1366190068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3732 SABINE PASS DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711116359",
            "telephone_number": "318-560-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LINE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014639",
            "telephone_number": "318-213-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3732 Sabine Pass Dr",
            "address_purpose": "LOCATION",
            "city": "Bossier City",
            "state": "LA",
            "postal_code": "711116359",
            "country_code": "US",
            "telephone_number": "318-560-4979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "LINDSAY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-13",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "143088",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "226655",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 11, 2022; 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.