Individual provider Active NPI

Ernest L Kistler, MD

  • Anesthesiology Physician
  • Shreveport, LA
National Provider Identifier
1750362109
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
014584 Issued in LA
Practice address
1 Saint Mary PL
Anesthesia Dept
Shreveport, LA 71101-4343
Phone
(866) 214-8600
Fax
(888) 411-4191
NPI assigned
Nov 10, 2005
Last updated
Feb 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 014584 LA Primary

Addresses

Primary practice location

1 Saint Mary PL
Anesthesia Dept
Shreveport, LA 71101-4343

Mailing address

PO Box 9600
Dept 09-039
Texarkana, TX 75505-9600
Phone (866) 214-8600

Other identifiers 2

IdentifierTypeStateIssuer
1344877MedicaidLA
050016353OtherLAMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
014584LAMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1750362109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9600",
            "address_2": "DEPT 09-039",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755059600",
            "telephone_number": "866-214-8600",
            "fax_number": "888-411-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT MARY PL",
            "address_2": "ANESTHESIA DEPT",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014343",
            "telephone_number": "866-214-8600",
            "fax_number": "888-411-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTLER",
        "first_name": "ERNEST",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "014584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1344877",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "050016353",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.