Individual provider Active NPI

Jerred Anderson, CRNA

  • Certified Registered Nurse Anesthetist
  • Crowley, LA
National Provider Identifier
1427448646
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN126584 Issued in LA
Practice address
1305 Crowley Rayne Hwy
Crowley, LA 70526-8202
Phone
(337) 783-3222
NPI assigned
Jan 26, 2015
Last updated
Jan 30, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 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 RN126584 LA Primary

Addresses

Primary practice location

1305 Crowley Rayne Hwy
Crowley, LA 70526-8202

Mailing address

3510 N Causeway Blvd Ste 404
Metairie, LA 70002-3531
Phone (504) 779-5515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150317001397 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567789241 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Anesthesia LLCGroup PAC ID 3476527946, 6 clinicians

Practice addresses (Care Compare)

2106 Loop Rd
Winnsboro, LA 71295-3344
Phone (318) 282-8482

254 Hwy 3048
Rayville, LA 71269-3624
Phone (318) 728-4181

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Arts

State licenses

LicenseStateTypeSpecialty
RN126584LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Richland Parish Hospital Service District No. 1-B CurrentSince Dec 24, 2016 Accepting new patients
Richland Parish Hospital Service District No 1-B Current Accepting new patients
Richland Parish Hospital Service District No 1-B CurrentSince Dec 24, 2016 Accepting new patients
Riverside Anesthesia LLC CurrentSince Jan 4, 2016 Accepting new patients

Locations

323 W Walnut Ave
Bastrop, LA 71220
Phone (318) 283-3600

407 Cincinnati St
Delhi, LA 71232
Phone (318) 878-5171

129 Christian Dr
Rayville, LA 71269
Phone (318) 728-0028

254 Highway 3048
Rayville, LA 71269
Phone (318) 728-4181

107 Front St
Vidalia, LA 71373
Phone (318) 336-2216

2106 Loop Rd
Winnsboro, LA 71295
Phone (318) 282-8482

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422576000000",
    "number": "1427448646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 N CAUSEWAY BLVD STE 404",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700023531",
            "telephone_number": "504-779-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 CROWLEY RAYNE HWY",
            "city": "CROWLEY",
            "state": "LA",
            "postal_code": "705268202",
            "telephone_number": "337-783-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JERRED",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN126584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crowley, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.