Individual provider Active NPI

Anice Hayes Wheeler, CRNA

  • Certified Registered Nurse Anesthetist
  • Monroe, LA
National Provider Identifier
1962597914
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
043930/01449 Issued in LA
Practice address
2408 Broadmoor Blvd
Monroe, LA 71201-2963
Phone
(318) 410-0002
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 043930/01449 LA Primary

Addresses

Primary practice location

2408 Broadmoor Blvd
Monroe, LA 71201-2963

Mailing address

30 Quail Ridge Dr
Monroe, LA 71203-9629
Phone (318) 343-7267

Other identifiers 1

IdentifierTypeStateIssuer
1390372MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
043930/01449LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Partners PA Nurse Anesthetist, Certified Registered PastSince Mar 5, 2012 Accepting new patients
Fontenot & McIntosh, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Twin City Anesthesia Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962597914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 QUAIL RIDGE DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712039629",
            "telephone_number": "318-343-7267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 BROADMOOR BLVD",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712012963",
            "telephone_number": "318-410-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "ANICE",
        "middle_name": "HAYES",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "043930/01449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1390372",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.