Individual provider Active NPI

John Enoch Vincent, CRNA

  • Certified Registered Nurse Anesthetist
  • Baton Rouge, LA
National Provider Identifier
1679844088
Registry record updated Jun 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
TAP002736 Issued in LA
Practice address
8212 Summa Ave
Baton Rouge, LA 70809-3421
Phone
(225) 769-4403
Fax
(225) 769-3842
NPI assigned
Jan 17, 2012
Last updated
Jun 15, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2017

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 TAP002736 LA Primary

Addresses

Primary practice location

8212 Summa Ave
Baton Rouge, LA 70809-3421

Mailing address

100 Womans Way
Baton Rouge, LA 70817-5100
Phone (225) 924-8149

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120306000334 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1759540032 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dpi of Louisiana LLCGroup PAC ID 1456886365, 72 clinicians
Riverside Anesthesia LLCGroup PAC ID 3476527946, 6 clinicians

Practice addresses (Care Compare)

17000 Medical Ctr Dr
Baton Rouge, LA 70816-3246
Phone (225) 752-2470

2106 Loop Rd
Winnsboro, LA 71295-3344
Phone (318) 282-8482

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TAP002736LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Dpi of Louisiana LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2025 Accepting new patients
Diversified Professionals, Inc. CurrentSince May 1, 2023 Accepting new patients
Anesthesiology Group Associates Inc PastSince Jan 14, 2008 Accepting new patients
Zachary ASC Partners, LLC Past Accepting new patients
St. Tammany Pathology Past Accepting new patients

Locations

17000 Medical Center Dr
Baton Rouge, LA 70816
Phone (225) 752-2470

7145 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 765-3111

7301 Hennessy Blvd
#100
Baton Rouge, LA 70808
Phone (225) 215-3443

8946 Interline Ave
Ste C
Baton Rouge, LA 70809
Phone (225) 529-1143

6550 Main St
Ste 2600
Zachary, LA 70791
Phone (225) 570-6357

Organizations & group practices 6

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 1

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": "1326758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497484800000",
    "number": "1679844088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WOMANS WAY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708175100",
            "telephone_number": "225-924-8149",
            "fax_number": "225-293-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8212 SUMMA AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093421",
            "telephone_number": "225-769-4403",
            "fax_number": "225-769-3842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "JOHN",
        "middle_name": "ENOCH",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-17",
        "last_updated": "2017-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "TAP002736",
            "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 Jun 15, 2017; 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.