Connie Sanderlin, CRNA

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RNO97669 Issued in LA

Practice address

600 South Pine Street
Deridder, LA 70634-0730

Phone

(337) 462-7100

NPI assigned

Jul 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Willis Knighton Medical Center Inc Crna GroupGroup PAC ID 1759358674, 93 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Willis Knighton Medical Center Inc. Crna Group

  • Anesthesiology Physician
  • Shreveport, LA
  • NPI 1174546097
  Medicare reassignment Care Compare group NPD
• Med-Trans Corporation

  • Air Ambulance
  • Foley, AL
  • NPI 1275084535
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236816000000",
    "number": "1861417990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SOUTH PINE STREET",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706340730",
            "telephone_number": "337-462-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SOUTH PINE STREET",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706340730",
            "telephone_number": "337-462-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERLIN",
        "first_name": "CONNIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2009-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RNO97669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1712558",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Anthony Roy, RPH
• James R Rudd Sr., M.D.
• James Robert Rudd Jr., M.D.
• Robert C Rushford, CRNA
• Jocelyn Salinas
• Marta Lichtl Schexnayder, MCD-CCC/SLP
• Serenity Child and Youth Counseling, LLC
• Mason Shaw, DPT
• James T Shirley, D.D.S.
• Thomas Herbert Shirley, DDS

• Registered Nurse in Deridder, LA
• Providers in Deridder, LA by specialty
• Registered Nurse in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.