NPIMap

Organization Active NPI

Christus Health Northern Louisiana

Doing business as Christus Shreveport-Bossier Health System

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
National Provider Identifier
1801822762
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
193 Issued in LA
Legal business name
CHRISTUS HEALTH NORTHERN LOUISIANA
Doing business as
Christus Shreveport-Bossier Health System
Practice address
1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800
Phone
(318) 681-4500
Fax
(318) 681-4177
NPI assigned
Jun 23, 2006
Last updated
Oct 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Authorized official

Name
Thomas Steen Trawick
Title
Ceo
Phone
(318) 681-5054

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 193 LA Primary

Addresses

Primary practice location

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800

Mailing address

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800
Phone (318) 681-4500

Other identifiers 2

IdentifierTypeStateIssuer
1945897MedicaidLA
H3938OtherLABCBS

Other names 1

  • CHRISTUS SHREVEPORT-BOSSIER HEALTH SYSTEM Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060111000997 LA Part B Supplier - Clinic/Group Practice 8628980554 Receives reassigned benefits from 67 practitioners
1 other NPI on this enrollment
Practice locations: Shreveport, LA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Christus Schumpert Health System4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

1453 E Bert Kouns Indst Lop
Dallas, TX 75284

Practitioners & affiliated clinicians

Practitioners 67

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1801822762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1453 E BERT KOUNS INDUSTRIAL LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711056800",
            "telephone_number": "318-681-4500",
            "fax_number": "318-681-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 E BERT KOUNS INDUSTRIAL LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711056800",
            "telephone_number": "318-681-4500",
            "fax_number": "318-681-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTUS HEALTH NORTHERN LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A",
        "authorized_official_last_name": "TRAWICK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "STEEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-681-5054"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1945897",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "H3938",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTUS SHREVEPORT-BOSSIER HEALTH SYSTEM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.