Individual provider Active NPI

Cynthia Rosenberry, CRNA

  • Certified Registered Nurse Anesthetist
  • Gulfport, MS
National Provider Identifier
1710961016
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
901632 Issued in MS
Practice address
4500 13TH St
Second Floor Main Tower
Gulfport, MS 39501
Phone
(228) 865-3281
Fax
(228) 867-5117
NPI assigned
Dec 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP01399 LA
Certified Registered Nurse Anesthetist 367500000X 901632 MS Primary

Addresses

Primary practice location

4500 13TH St
Second Floor Main Tower
Gulfport, MS 39501

Mailing address

4500 13TH St
Second Floor Main Tower
Gulfport, MS 39501
Phone (228) 865-3281

Other identifiers 1

IdentifierTypeStateIssuer
1393967MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040119000200 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183525561 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lafayette Health Ventures IncGroup PAC ID 9335043074, 299 clinicians

Practice addresses (Care Compare)

1214 Coolidge Blvd
Lafayette, LA 70503-2621
Phone (337) 289-7991

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP01399LAMDCertified Registered Nurse Anesthetist
901632MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Affiliates, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2023 Accepting new patients
University Health Shreveport LLC CurrentSince Nov 2, 2020 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice CurrentSince Nov 2, 2020 Accepting new patients
Anesthesiology & Pain Consultants, LLC CurrentSince Nov 1, 2014 Accepting new patients
Ochsner Clinic LLC Past Accepting new patients
Ochsner Clinic LLC Past Accepting new patients

Locations

9103 Jefferson Hwy
Baton Rouge, LA 70809
Phone (225) 927-1190

1103 Kaliste Saloom Rd
Ste 304
Lafayette, LA 70508
Phone (318) 981-3546

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 8

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 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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1710961016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "address_2": "SECOND FLOOR MAIN TOWER",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "228-865-3281",
            "fax_number": "228-867-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "address_2": "SECOND FLOOR MAIN TOWER",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "228-865-3281",
            "fax_number": "228-867-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERRY",
        "first_name": "CYNTHIA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP01399",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "901632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1393967",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; 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.