NPIMap

Individual provider Active NPI

Randall Verzwyvelt, CRNA

  • Certified Registered Nurse Anesthetist
  • Longview, TX
National Provider Identifier
1861763278
Registry record updated Jan 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
808502 Issued in TX
Practice address
2901 N 4TH St
Longview, TX 75605-5128
Phone
(903) 758-1818
NPI assigned
Jan 17, 2012
Last updated
Jan 17, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2012

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 808502 TX Primary

Addresses

Primary practice location

2901 N 4TH St
Longview, TX 75605-5128

Mailing address

512 Meadowbrook Dr
Longview, TX 75601-3819
Phone (225) 241-3849

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140122001566 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850551771 Reassigns benefits to 2 organizations

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
Mid-Louisiana Anesthesia Consultants, ApmcGroup PAC ID 3971408733, 53 clinicians
Youngs Professional Services LLCGroup PAC ID 2163524992, 297 clinicians

Practice addresses (Care Compare)

1444 Peterman Dr
Alexandria, LA 71301-3432
Phone (318) 442-5399

651 N Bolton Ave
Alexandria, LA 71301-7449
Phone (318) 443-3511

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Louisiana Anesthesia Consultants, Apmc CurrentSince Oct 30, 2013 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 17, 2020 Accepting new patients

Locations

1444 Peterman Dr
Alexandria, LA 71301
Phone (318) 442-5399

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

211 4th St
#30135
Alexandria, LA 71301
Phone (318) 448-4440

651 N Bolton Ave
Alexandria, LA 71301
Phone (318) 443-3511

1100 Andre St
Ste 300
New Iberia, LA 70563
Phone (337) 364-9225

Organizations & group practices 2

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326758400000",
    "number": "1861763278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 MEADOWBROOK DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756013819",
            "telephone_number": "225-241-3849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 N 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055128",
            "telephone_number": "903-758-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERZWYVELT",
        "first_name": "RANDALL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-17",
        "last_updated": "2012-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "808502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; 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.