Individual provider Active NPI

Kellsi Castleberry

  • Certified Registered Nurse Anesthetist
  • Metairie, LA
National Provider Identifier
1972131746
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
225798 Issued in LA
Practice address
5929 W Metairie Ave
Metairie, LA 70003-4245
Phone
(504) 717-3734
NPI assigned
Mar 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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 225798 LA Primary

Addresses

Primary practice location

5929 W Metairie Ave
Metairie, LA 70003-4245

Mailing address

5929 W Metairie Ave
Metairie, LA 70003-4245
Phone (504) 717-3734

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220623002527 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305225210 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Hospital Anesthesia CorporationGroup PAC ID 0446152862, 281 clinicians

Practice addresses (Care Compare)

1401 Foucher St
New Orleans, LA 70115-3515
Phone (504) 897-7011

Hospital & facility affiliations

  • East Jefferson General Hospital Hospital, Metairie, LA, CCN 190176

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
225798LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital Anesthesia Corporation CurrentSince Jun 13, 2022 Accepting new patients
Prime Anesthesia Services Nurse Anesthetist, Certified Registered CurrentSince Apr 23, 2024 Accepting new patients

Locations

3636 S I 10 Service Rd W
Ste 204
Metairie, LA 70001
Phone (504) 218-4936

1401 Foucher St
New Orleans, LA 70115
Phone (504) 897-7011

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1585440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1972131746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5929 W METAIRIE AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700034245",
            "telephone_number": "504-717-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5929 W METAIRIE AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700034245",
            "telephone_number": "504-717-3734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTLEBERRY",
        "first_name": "KELLSI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-29",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "225798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.