NPIMap

Organization Active NPI

Northshore Anesthesia Practice, LLC

  • Certified Registered Nurse Anesthetist
  • Ponchatoula, LA
National Provider Identifier
1467833574
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN098829AP05096 Issued in LA
Legal business name
NORTHSHORE ANESTHESIA PRACTICE, LLC
Practice address
24575 Verneiul LN
Ponchatoula, LA 70454-6211
Phone
(985) 687-7656
NPI assigned
Jun 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Authorized official

Name
Mr. David Michael Burdett, CRNA
Title
Owner
Phone
(985) 687-7656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X RN098829AP05096 LA Primary

Addresses

Primary practice location

24575 Verneiul LN
Ponchatoula, LA 70454-6211

Mailing address

24575 Verneiul LN
Ponchatoula, LA 70454-6211
Phone (985) 687-7656

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1467833574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24575 VERNEIUL LN",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704546211",
            "telephone_number": "985-687-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24575 VERNEIUL LN",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704546211",
            "telephone_number": "985-687-7656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE ANESTHESIA PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "BURDETT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-687-7656",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN098829AP05096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponchatoula, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.