Individual provider Active NPI

Kenneth Crum

  • Certified Registered Nurse Anesthetist
  • Baton Rouge, LA
National Provider Identifier
1568052215
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
218400 Issued in LA
Practice address
5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone
(225) 765-6565
NPI assigned
Jan 26, 2021
Last updated
Jan 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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 218400 LA Primary

Addresses

Primary practice location

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375

Mailing address

7777 Hennessy Blvd Ste 301
Baton Rouge, LA 70808-0319
Phone (225) 214-6438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, WY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210210000872 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103231899 Reassigns benefits to 2 organizations
I20250915001602 WY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103231899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LCMS Cardiovascular Diseases, LLCGroup PAC ID 1951541515, 34 clinicians

Practice addresses (Care Compare)

1701 Oak Park Blvd
Lake Charles, LA 70601-8911
Phone (337) 494-3255

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218400LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Group Associates Inc CurrentSince Feb 1, 2021 Accepting new patients
LCMS Cardiovascular Diseases, LLC CurrentSince Jul 22, 2022 Accepting new patients
Frontier Anesthesia LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

11414 Lake Sherwood Ave N
Baton Rouge, LA 70816
Phone (225) 532-4058

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

7777 Hennessy Blvd
Ste 301
Baton Rouge, LA 70808
Phone (225) 214-6436

9032 Perkins Rd
Baton Rouge, LA 70810
Phone (225) 358-4853

1701 Oak Park Blvd
Lake Charles, LA 70601
Phone (337) 494-3000

7220 Commons Cir
Cheyenne, WY 82009
Phone (307) 635-4141

Organizations & group practices 3

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": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1568052215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD STE 301",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708080319",
            "telephone_number": "225-214-6438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 HENNESSY BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084375",
            "telephone_number": "225-765-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUM",
        "first_name": "KENNETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "218400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.