Individual provider Active NPI

Klisa D. Hargrove-Loper, CRNA

  • Certified Registered Nurse Anesthetist
  • Pomona, NJ
National Provider Identifier
1013189968
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1057442 Issued in TX
Practice address
65 W Jimmie Leeds Rd
Pomona, NJ 08240-9102
Phone
(609) 652-3444
NPI assigned
Apr 1, 2008
Last updated
May 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 26NR10700600 NJ
Certified Registered Nurse Anesthetist 367500000X 1057442 TX Primary

Addresses

Primary practice location

65 W Jimmie Leeds Rd
Pomona, NJ 08240-9102

Mailing address

255 W Michigan Ave
Jackson, MI 49201-2218
Phone (517) 787-6440

Other practice location 1

12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Phone (972) 715-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220202000458 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113093105 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
U S Anesthesia Partners of Texas, PAGroup PAC ID 7315850351, 2,750 clinicians

Practice addresses (Care Compare)

4401 Booth Calloway Rd
North Richland Hills, TX 76180-7371
Phone (817) 255-1195

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NR10700600NJMDCertified Registered Nurse Anesthetist
1057442TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Pain Relief Group PLLC CurrentSince Oct 2, 2023 Accepting new patients
Texas Pain Relief Group, PLLC CurrentSince Oct 2, 2023 Accepting new patients

Locations

1717 Precinct Line Rd
Ste 200
Hurst, TX 76054
Phone (817) 369-3990

Organizations & group practices 4

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 2

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": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1013189968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 W JIMMIE LEEDS RD",
            "city": "POMONA",
            "state": "NJ",
            "postal_code": "082409102",
            "telephone_number": "609-652-3444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12222 Merit Dr Ste 600",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752513294",
            "country_code": "US",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARGROVE-LOPER",
        "first_name": "KLISA",
        "middle_name": "D.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NR10700600",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1057442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.