Brian Grissom, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN097498 Issued in LA

Practice address

1202 S Tyler St
Covington, LA 70433-2330

Phone

(985) 898-4000

NPI assigned

Jun 26, 2006

Last updated

Oct 30, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Total Anesthesia Care STPH, LLC

  • Anesthesiology Physician
  • Covington, LA
  • NPI 1669475190
  Medicare reassignment

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256860800000",
    "number": "1639106891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 INNWOOD DR",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704339123",
            "telephone_number": "985-892-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 S TYLER ST",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704332330",
            "telephone_number": "985-898-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISSOM",
        "first_name": "BRIAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2009-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN097498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1563421",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert J Grieshaber, MD
• Richard A Grimaldi, CNIM
• Mary Payton Grimmett
• Stratton Grisoli, M.D.
• Addison Grissett, MS, CCC-SLP
• Geoffrey Paul Gros, PHARM.D.
• Heather Leblanc Gros, APRN, AGACNP
• Mack Jay Groves IV, DPM
• Lloyd Joseph Gueringer Jr., MD
• Melissa Labourdette Gueringer, APRN, FNP-C

• Certified Registered Nurse Anesthetist in Covington, LA
• Providers in Covington, LA by specialty
• Certified Registered Nurse Anesthetist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.