Active NPI
Clay Anthony Miller, CRNA
- Certified Registered Nurse Anesthetist
- Shreveport, LA
National Provider Identifier
1780771352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN044445
- Practice address
- 255 Bert Kouns Loop
Shreveport, LA 71106-8150 - Phone
- (318) 683-0411
- Fax
- (318) 683-0743
- NPI assigned
- Oct 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN044445 | LA | Primary |
Addresses
Primary practice location
255 Bert Kouns Loop
Shreveport, LA 71106-8150
Mailing address
1 Saint Mary Place
PFS-Prof Billing
Shreveport, LA 71101
Phone (318) 681-6878
Other practice location 1
1 Saint Mary Place
PFS-Prof Billing
Shreveport, LA 71101
Phone (318) 681-6878
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1960357 | Medicaid | LA |
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
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN044445 | LA | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641513600000",
"number": "1780771352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 SAINT MARY PLACE",
"address_2": "PFS-PROF BILLING",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "71101",
"telephone_number": "318-681-6878",
"fax_number": "318-681-6753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 BERT KOUNS LOOP",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711068150",
"telephone_number": "318-683-0411",
"fax_number": "318-683-0743"
}
],
"practiceLocations": [
{
"address_1": "1 SAINT MARY PLACE",
"address_2": "PFS-PROF BILLING",
"address_purpose": "LOCATION",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "71101",
"country_code": "US",
"telephone_number": "318-681-6878",
"fax_number": "318-681-6753",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLER",
"first_name": "CLAY",
"middle_name": "ANTHONY",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2022-01-07",
"certification_date": "2022-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "LA",
"license": "RN044445",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1960357",
"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 Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.