Individual provider Active NPI

Joshua Wayne Vicknair, CRNA

  • Certified Registered Nurse Anesthetist
  • Metairie, LA
National Provider Identifier
1457515090
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN108454 Issued in LA
Practice address
3510 N Causeway Blvd
Suite 404
Metairie, LA 70002-3531
Phone
(504) 779-5515
NPI assigned
Jul 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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 RN108454 LA Primary

Addresses

Primary practice location

3510 N Causeway Blvd
Suite 404
Metairie, LA 70002-3531

Mailing address

255 W Michigan Ave
PO Box 1123
Jackson, MI 49201-2218
Phone (800) 242-1131

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080922000467 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3971670647 Reassigns benefits to 5 organizations

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
Childrens Hospital Anesthesia CorporationGroup PAC ID 0446152862, 281 clinicians

Practice addresses (Care Compare)

1101 Medical Ctr Blvd
Marrero, LA 70072-3147
Phone 8662148600203

Hospital & facility affiliations

  • West Jefferson Medical Center Hospital, Marrero, LA, CCN 190039
  • New Orleans East Hospital Hospital, New Orleans, LA, CCN 190313

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN108454LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Sep 24, 2023 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G Current Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Apr 1, 2019 Accepting new patients
Childrens Hospital Anesthesia Corporation CurrentSince Mar 1, 2017 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Sep 24, 2023 Accepting new patients
University Medical Center Management Corporation CurrentSince May 1, 2022 Accepting new patients
University Medical Center Management Corporation CurrentSince May 1, 2022 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Apr 1, 2019 Accepting new patients
Zephyr Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2012 Accepting new patients
Tuhc Anesthesiology Group LLC Past Accepting new patients

Locations

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

8000 W Judge Perez Dr
Chalmette, LA 70043
Phone (504) 493-6078

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

694 Belle Terre Blvd
La Place, LA 70068
Phone (985) 359-6694

1645 Lutcher Ave
Lutcher, LA 70071
Phone (225) 258-5901

1101 Medical Center Blvd
Marrero, LA 70072
Phone (504) 347-5511

4700 S I 10 Svc Rd W
Metairie, LA 70001
Phone (504) 780-6453

3510 N Causeway Blvd
Ste 404
Metairie, LA 70002
Phone 5047795515 ext. 216

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

1717 Saint Charles Ave
New Orleans, LA 70130
Phone (504) 529-6600

1415 Tulane Ave
Fl 3
New Orleans, LA 70112
Phone (504) 988-5271

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

2000 Canal St
New Orleans, LA 70112
Phone (504) 702-2287

1542 Tulane Ave
New Orleans, LA 70112
Phone (504) 866-2741

478 S Johnson St
New Orleans, LA 70112
Phone (504) 412-1366

2500 Belle Chasse Hwy
Terrytown, LA 70056
Phone (504) 391-5157

Organizations & group practices 10

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 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": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1457515090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "address_2": "PO BOX 1123",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "800-242-1131",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 N CAUSEWAY BLVD",
            "address_2": "SUITE 404",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700023531",
            "telephone_number": "504-779-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKNAIR",
        "first_name": "JOSHUA",
        "middle_name": "WAYNE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-14",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN108454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.