Individual provider Active NPI

Derek Leonard Hines, CRNA

  • Certified Registered Nurse Anesthetist
  • Slidell, LA
National Provider Identifier
1841454956
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP05510 Issued in LA
Practice address
636 Gause Blvd
Suite 200
Slidell, LA 70458-2007
Phone
(985) 641-8008
Fax
(985) 649-4063
NPI assigned
Jul 17, 2008
Last updated
Jul 17, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 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 AP05510 LA Primary

Addresses

Primary practice location

636 Gause Blvd
Suite 200
Slidell, LA 70458-2007

Mailing address

PO Box 3249
Slidell, LA 70459-3249
Phone (985) 641-8008

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081117000632 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911067244 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Anesthesia Care STPH LLCGroup PAC ID 0749255909, 65 clinicians

Practice addresses (Care Compare)

1202 S Tyler St
Covington, LA 70433-2330
Phone (985) 898-4583

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP05510LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northlake Anesthesiologists, a Professional Corporation CurrentSince Jun 26, 2008 Accepting new patients
Total Anesthesia Care STPH, LLC CurrentSince Jan 27, 2014 Accepting new patients
The Spine Management Center,LLC Past Accepting new patients
A. Waring, LLC Past Accepting new patients

Locations

120 Innwood Dr
Covington, LA 70433

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

1700 Lindberg Dr
Slidell, LA 70458
Phone (800) 598-7291

636 Gause Blvd
Ste 200
Slidell, LA 70458
Phone (985) 641-8008

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216252800000",
    "number": "1841454956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3249",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704593249",
            "telephone_number": "985-641-8008",
            "fax_number": "985-649-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 GAUSE BLVD",
            "address_2": "SUITE 200",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582007",
            "telephone_number": "985-641-8008",
            "fax_number": "985-649-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES",
        "first_name": "DEREK",
        "middle_name": "LEONARD",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP05510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.