Individual provider Active NPI

Charles R. Lowrance, CRNA

  • Certified Registered Nurse Anesthetist
  • Tyler, TX
National Provider Identifier
1821097007
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
228195 Issued in TX
Practice address
1424 East Front
Tyler, TX 75702
Phone
(903) 595-4144
Fax
(903) 596-7541
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 228195 TX Primary

Addresses

Primary practice location

1424 East Front
Tyler, TX 75702

Mailing address

PO Box 130639
Tyler, TX 75713
Phone (903) 595-4144

Other identifiers 1

IdentifierTypeStateIssuer
84114COtherTXBLUE CROSS BLUE SHIELD

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
228195TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
East Texas Medical Center Past Accepting new patients
Turtle Creek Surgery Center LLC Past Accepting new patients
Presbyterian Hospital of Dallas Nurse Anesthetist, Certified Registered Past Accepting new patients
East Texas Medical Center Nurse Anesthetist, Certified Registered Past Accepting new patients
Horizon Anesthesia Associates PA PastSince Jul 25, 2016 Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206403200000",
    "number": "1821097007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130639",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75713",
            "telephone_number": "903-595-4144",
            "fax_number": "903-596-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 EAST FRONT",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75702",
            "telephone_number": "903-595-4144",
            "fax_number": "903-596-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWRANCE",
        "first_name": "CHARLES",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2008-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "228195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "84114C",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; 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.