Walter Kennedy, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN039167 Issued in LA

Practice address

401 E Vaughn Ave
Ruston, LA 71270-5950

Phone

(318) 254-2100

Fax

(318) 254-2728

NPI assigned

Sep 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

91.8 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

72.66

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Arena Anesthesia LLC

  • Anesthesiology Physician
  • Ruston, LA
  • NPI 1023244779

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Joseph E Humble and Raymond Haik, PTRS

  • Ophthalmology Physician
  • West Monroe, LA
  • NPI 1336178482
  Medicare reassignment NPD
• Joseph E Humble and Raymond Haik, PTRS

  • Eyewear Supplier
  • Rayville, LA
  • NPI 1154976157
  NPD
• Green Clinic Surgical Center

  • Ambulatory Surgical Clinic/Center
  • Ruston, LA
  • NPI 1861581092
  NPD (past)

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1730375288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25108",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374225108",
            "telephone_number": "318-254-2100",
            "fax_number": "318-254-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E VAUGHN AVE",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705950",
            "telephone_number": "318-254-2100",
            "fax_number": "318-254-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "WALTER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-19",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN039167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Certified Registered Nurse Anesthetist in Ruston, LA
• Providers in Ruston, LA by specialty
• Certified Registered Nurse Anesthetist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.