Individual provider Active NPI

Leonard Paul Linke Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Victoria, TX
National Provider Identifier
1679803803
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
595668 Issued in TX
Practice address
2701 Hospital Dr
Victoria, TX 77901-5748
Phone
(361) 573-9181
NPI assigned
Jan 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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 595668 TX Primary

Addresses

Primary practice location

2701 Hospital Dr
Victoria, TX 77901-5748

Mailing address

2701 Hospital Dr
Victoria, TX 77901-5748
Phone (361) 573-9181

Other practice location 1

6404 Nursery Dr Ste 300
Victoria, TX 77904-1688
Phone (361) 570-8311

Other practice location 2

815 N Virginia St
Port Lavaca, TX 77979-3025
Phone (361) 552-6713

Other identifiers 1

IdentifierTypeStateIssuer
211755801MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100428000352 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890822506 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
595668TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Citizen's Medical Center County of Victoria CurrentSince Apr 1, 2022 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 23, 2019 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

815 N Virginia St
Port Lavaca, TX 77979
Phone (361) 552-0325

1305 Wonder World Dr
Ste 105
San Marcos, TX 78666
Phone (512) 353-8161

5404 Summerhill Rd
Texarkana, TX 75503
Phone (903) 792-3773

2701 Hospital Dr
Victoria, TX 77901
Phone (361) 573-9180

6404 Nursery Dr
Ste 300
Victoria, TX 77904
Phone (361) 570-8311

2701 Hospital Dr
Fl 6
Victoria, TX 77901
Phone (361) 572-5113

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1679803803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 HOSPITAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015748",
            "telephone_number": "361-573-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 HOSPITAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015748",
            "telephone_number": "361-573-9181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6404 Nursery Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Victoria",
            "state": "TX",
            "postal_code": "779041688",
            "country_code": "US",
            "telephone_number": "361-570-8311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "815 N Virginia St",
            "address_purpose": "LOCATION",
            "city": "Port Lavaca",
            "state": "TX",
            "postal_code": "779793025",
            "country_code": "US",
            "telephone_number": "361-552-6713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINKE",
        "first_name": "LEONARD",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-11",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "595668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211755801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.