Individual provider Active NPI

Marie Latiolais Ostheimer, CRNA

  • Certified Registered Nurse Anesthetist
  • Longview, TX
National Provider Identifier
1477791259
Registry record updated Jun 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
TEMP Issued in TX
Practice address
2901 N 4TH St
Longview, TX 75605-5128
Phone
(903) 758-1818
NPI assigned
Feb 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2009

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 TEMP TX Primary

Addresses

Primary practice location

2901 N 4TH St
Longview, TX 75605-5128

Mailing address

2901 N 4TH St
Longview, TX 75605-5128
Phone (903) 758-1818

Other identifiers 1

IdentifierTypeStateIssuer
201365801MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141201000498 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133276017 Reassigns benefits to 1 organization

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
Anesthesiology and Pain Consultants LLCGroup PAC ID 3870490402, 48 clinicians

Practice addresses (Care Compare)

1103 Kaliste Saloom Rd
Suite 304
Lafayette, LA 70508-5784
Phone (337) 988-5646

Hospital & facility affiliations

National Provider Directory

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

Organizations & group practices 1

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 2

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": "1233446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245715200000",
    "number": "1477791259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 N 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055128",
            "telephone_number": "903-758-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 N 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055128",
            "telephone_number": "903-758-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTHEIMER",
        "first_name": "MARIE",
        "middle_name": "LATIOLAIS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-01",
        "last_updated": "2009-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "TEMP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201365801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2009; 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.