Individual provider Active NPI

Lawrence Zachary Gardanier

  • Certified Registered Nurse Anesthetist
  • Jonesboro, AR
National Provider Identifier
1891536611
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
148772 Issued in AR
Practice address
225 E Washington Ave
Jonesboro, AR 72401-3111
Phone
(870) 207-4100
NPI assigned
Jun 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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 148772 AR Primary

Addresses

Primary practice location

225 E Washington Ave
Jonesboro, AR 72401-3111

Mailing address

3639 Red Maple Way
Jonesboro, AR 72404-5041
Phone (801) 310-5686

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240620003087 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567905300 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
148772ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Jonesboro Anesthesia Inc CurrentSince Jul 29, 2024 Accepting new patients

Locations

225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630

1100 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-8500

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jonesboro Anesthesia Inc 60 clinicians

Practice addresses (Care Compare)

1100 E Matthews Ave
Jonesboro, AR 72401-4314
Phone (870) 932-4211

Hospital & facility affiliations

  • St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020

NPI Registry JSON

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1891536611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3639 RED MAPLE WAY",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724045041",
            "telephone_number": "801-310-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E WASHINGTON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013111",
            "telephone_number": "870-207-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDANIER",
        "first_name": "LAWRENCE",
        "middle_name": "ZACHARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "148772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.