Individual provider Active NPI

Robert Nathaniel Ladd, CRNA

  • Certified Registered Nurse Anesthetist
  • Jacksonville, FL
National Provider Identifier
1962578534
Registry record updated Jan 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
43256 Issued in KY
Practice address
NH Jacksonville
2080 Child St
Jacksonville, FL 32214-0001
Phone
(904) 542-7632
NPI assigned
Nov 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2009

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 43256 KY Primary

Addresses

Primary practice location

NH Jacksonville
2080 Child St
Jacksonville, FL 32214-0001

Mailing address

9072 Redtail Dr
Jacksonville, FL 32222-2836
Phone (803) 210-7741

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081202000475 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799769048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Treasure Coast Anesthesia Group PAGroup PAC ID 2567600588, 98 clinicians

Practice addresses (Care Compare)

200 SE Hospital Ave
Stuart, FL 34994-2346
Phone (772) 287-5200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5058KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Treasure Coast Anesthesia Group PA Nurse Anesthetist, Certified Registered CurrentSince May 4, 2015 Accepting new patients

Locations

10080 SW Innovation Way
Ste 101
Port St Lucie, FL 34987
Phone (561) 358-2445

10000 SW Innovation Way
Port St Lucie, FL 34987
Phone (772) 288-5853

2100 SE Salerno Rd
Stuart, FL 34997
Phone (772) 223-2300

509 SE Riverside Dr
Stuart, FL 34994
Phone (772) 223-2300

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

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.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232409600000",
    "number": "1962578534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9072 REDTAIL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322222836",
            "telephone_number": "803-210-7741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NH JACKSONVILLE",
            "address_2": "2080 CHILD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322140001",
            "telephone_number": "904-542-7632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADD",
        "first_name": "ROBERT",
        "middle_name": "NATHANIEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2009-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "43256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.