Individual provider Active NPI

Charles David O'Con, CRNA

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
National Provider Identifier
1649382201
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN094033 Issued in LA
Practice address
510 E Stoner Ave
Shreveport, LA 71101-4243
Phone
(318) 841-4767
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 RN094033 LA Primary

Addresses

Primary practice location

510 E Stoner Ave
Shreveport, LA 71101-4243

Mailing address

9670 Calliope LN
Shreveport, LA 71115-4600
Phone (318) 798-6677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070525000412 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8426155474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Natchitoches Anesthesia Associates LLCGroup PAC ID 4981591088, 9 clinicians

Practice addresses (Care Compare)

501 Keyser Ave
Natchitoches, LA 71457-6018
Phone (318) 214-4200

Hospital & facility affiliations

  • Natchitoches Regional Medical Center Hospital, Natchitoches, LA, CCN 190007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Natchitoches Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 15, 2007 Accepting new patients
Med-Trans Corporation Past Accepting new patients
Twin City Anesthesia Past Accepting new patients
Willis Knighton Medical Center Inc. Crna Group Nurse Anesthetist, Certified Registered Past Accepting new patients
Red River Anesthesia of Alexandria, LLC Past Accepting new patients

Locations

501 Keyser Ave
Natchitoches, LA 71457
Phone (318) 214-4200

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649382201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9670 CALLIOPE LN",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711154600",
            "telephone_number": "318-798-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E STONER AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014243",
            "telephone_number": "318-841-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CON",
        "first_name": "CHARLES",
        "middle_name": "DAVID",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN094033",
            "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 Jul 8, 2007; 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.