Individual provider Active NPI

Jonathan Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
National Provider Identifier
1750977252
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1057014 Issued in TX
Practice address
1541 Kings Hwy
Shreveport, LA 71103-4228
Phone
(318) 626-0000
NPI assigned
Dec 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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 218598 LA
Certified Registered Nurse Anesthetist 367500000X 1057014 TX Primary

Addresses

Primary practice location

1541 Kings Hwy
Shreveport, LA 71103-4228

Mailing address

1512 W Kirby PL
Shreveport, LA 71103-3822
Phone (318) 626-0284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210219001285 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678988805 Reassigns benefits to 3 organizations
I20220519000373 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678988805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willis Knighton Medical Center Inc Crna GroupGroup PAC ID 1759358674, 93 clinicians

Practice addresses (Care Compare)

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 626-0000

8001 Youree Dr
Shreveport, LA 71115-2302
Phone (318) 212-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218598LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia III PA Nurse Anesthetist, Certified Registered CurrentSince Feb 11, 2022 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice CurrentSince Feb 12, 2021 Accepting new patients
Willis Knighton Medical Center Inc. Crna Group Nurse Anesthetist, Certified Registered CurrentSince Feb 7, 2025 Accepting new patients
University Health Shreveport LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 12, 2021 Accepting new patients
University Health Shreveport LLC CurrentSince Feb 12, 2021 Accepting new patients
Med-Trans Corporation Past Accepting new patients

Locations

3000 34th St
Metairie, LA 70001
Phone (504) 224-2506

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

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

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

911 Margaret Pl
Shreveport, LA 71101
Phone (318) 626-4200

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

8001 Youree Dr
Shreveport, LA 71115
Phone (318) 212-3000

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1750977252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 W KIRBY PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033822",
            "telephone_number": "318-626-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-626-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JONATHAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-18",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "218598",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1057014",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 3, 2024; 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.