Richard Bowlin, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Monroe, LA
NPI 1659445385 · NPPES record last updated Dec 31, 2024
Key facts
- NPI
- 1659445385
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- AP04650 (LA)
- Practice address
- 4864 Jackson St
Monroe, LA 71201 - Phone
- (318) 330-7626
- Fax
- (318) 330-7648
- NPI assigned
- Nov 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lsu Health Sciences Center Shreveport Faculty Group Practice
Practice addresses (Care Compare)
1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-5000
Hospital & facility affiliations
- Ochsner Lsu Health Monroe
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050803000031 | LA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 5991733636 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brfhh Monroe LLC | Current |
Accepting new patients | |
| Lsu Health Sciences Center Shreveport Faculty Group Practice | Current |
Accepting new patients | |
| Endoscopy Center of Monroe | Current |
Accepting new patients | |
| Joseph E Humble and Raymond Haik, PTRS | Current |
Accepting new patients | |
| Joseph E Humble and Raymond Haik, PTRS | Current |
Accepting new patients |
Locations
316 S 6th St
Monroe, LA 71201
Phone (318) 325-2634
2408 Broadmoor Blvd
Monroe, LA 71201
Phone (318) 410-0002
4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000
1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402
1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287
1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177
1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | AP04650 | LA | Yes |
Addresses
Primary practice location
4864 Jackson St
Monroe, LA 71201
Mailing address
4864 Jackson St
Monroe, LA 71201
Phone (318) 330-7626
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1038911 | Medicaid | LA |
NPI Registry JSON
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735603200000",
"number": "1659445385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4864 JACKSON ST",
"city": "MONROE",
"state": "LA",
"postal_code": "71201",
"telephone_number": "318-330-7626",
"fax_number": "318-330-7648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4864 JACKSON ST",
"city": "MONROE",
"state": "LA",
"postal_code": "71201",
"telephone_number": "318-330-7626",
"fax_number": "318-330-7648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWLIN",
"first_name": "RICHARD",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-17",
"last_updated": "2024-12-31",
"certification_date": "2024-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "LA",
"license": "AP04650",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1038911",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Monroe, LA
- Lloyd Joseph Boudloche Jr.
- Johnathan Ory Boudreaux
- Dan T Bounds
- Karen Renee Bounds
- Alex Bourgeois
- Kalvin Dewayne Bowman
- Kayli Bowman
- Shawta Michelle Boxley
- Gregory Arthur Boyce
- Jeremy Boyce
All providers in Monroe, LA · Certified Registered Nurse Anesthetist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.