Individual provider Active NPI

Martic Smith, CRNA

  • Certified Registered Nurse Anesthetist
  • Bossier City, LA
National Provider Identifier
1851402655
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN082737 AP03943 Issued in LA
Practice address
2105 Airline Dr
Bossier City, LA 71111-3105
Phone
(318) 549-2011
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 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 RN082737 AP03943 LA Primary

Addresses

Primary practice location

2105 Airline Dr
Bossier City, LA 71111-3105

Mailing address

2701 Long Branch LN
Shreveport, LA 71118-5027
Phone (318) 572-5474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VA, IA, NC4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20091014000653 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365549805 Reassigns benefits to 2 organizations
I20240119000153 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365549805 Reassigns benefits to 1 organization
I20240701003567 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365549805 Reassigns benefits to 1 organization
I20251203000246 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365549805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians

Practice addresses (Care Compare)

1001 Penn Ave
Ottumwa, IA 52501-6427
Phone (641) 684-2300

142 S Main St
Danville, VA 24541-2922
Phone (434) 799-3839

830 Rockford St
Mount Airy, NC 27030-5322
Phone (336) 719-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN082737 AP03943LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 5, 2024 Accepting new patients
Vista Doro Anesthesia, LLC CurrentSince Jan 5, 2025 Accepting new patients
Ams Baptist LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 15, 2010 Accepting new patients
Ams of Gulf Breeze LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2012 Accepting new patients
Ahp of Altamonte Springs LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Ahp of Orlando Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Outpatient Specialists Past Accepting new patients
Willis Knighton Medical Center Inc. Crna Group Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Health Care Partners of Florida Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Med-Trans Corporation Past Accepting new patients
Ahp of Northwestern Louisiana LLC Past Accepting new patients

Locations

123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

1001 Pennsylvania Ave
Ottumwa, IA 52501
Phone (641) 472-4111

830 Rockford St
Mount Airy, NC 27030
Phone (336) 719-7000

142 S Main St
Danville, VA 24541
Phone (434) 799-2100

6801 Governor Gc Peery Hwy
Richlands, VA 24641
Phone (276) 523-8600

Organizations & group practices 11

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 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1851402655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 LONG BRANCH LN",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711185027",
            "telephone_number": "318-572-5474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 AIRLINE DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711113105",
            "telephone_number": "318-549-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARTIC",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN082737 AP03943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.