Individual provider Active NPI

Rachel Lynn Payne, CRNA

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
National Provider Identifier
1558668368
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
114085 Issued in LA
Practice address
1501 Kings Hwy
Shreveport, LA 71103-4228
Phone
(318) 675-6684
Fax
(318) 675-6681
NPI assigned
Feb 15, 2011
Last updated
Feb 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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 114085 LA Primary

Addresses

Primary practice location

1501 Kings Hwy
Shreveport, LA 71103-4228

Mailing address

PO Box 5310
Shreveport, LA 71135-5310
Phone (318) 675-5584

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110302000421 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8426239088 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

745 Olive St
Suite 100
Shreveport, LA 71104-2246
Phone (318) 227-1163

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
114085LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University Health Shreveport LLC CurrentSince Oct 1, 2018 Accepting new patients
University Health Shreveport LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2018 Accepting new patients
Shreveport Surgery Center Ptrshp CurrentSince Feb 20, 2017 Accepting new patients
Shreveport Surgery Center Ptrshp Past Accepting new patients

Locations

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

745 Olive St
Ste 100
Shreveport, LA 71104
Phone (318) 227-0413

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.

NPI Registry JSON

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297728000000",
    "number": "1558668368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5310",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711355310",
            "telephone_number": "318-675-5584",
            "fax_number": "318-675-6681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-6684",
            "fax_number": "318-675-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "RACHEL",
        "middle_name": "LYNN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-15",
        "last_updated": "2011-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "114085",
            "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 Feb 15, 2011; 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.