Individual provider Active NPI

Melissa Ann Waterman, RN, CRNA

  • Certified Registered Nurse Anesthetist
  • Jbsa Ft Sam Houston, TX
National Provider Identifier
1013346733
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
825970 Issued in TX
Practice address
3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Phone
(570) 574-1992
NPI assigned
Nov 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R179446 MD
Registered Nurse 163W00000X 26NR12899400 NJ
Registered Nurse 163W00000X 624304 NY
Registered Nurse 163W00000X 215605 NC
Registered Nurse 163W00000X RN564419 PA
Registered Nurse 163W00000X 825970 TX
Certified Registered Nurse Anesthetist 367500000X AP125194 TX
Certified Registered Nurse Anesthetist 367500000X 825970 TX Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504

Mailing address

7751 Coughran Rd
Pleasanton, TX 78064-4435

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190403002726 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416298294 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Practice addresses (Care Compare)

1905 E State Hwy 97
Methodist Hospital Atascosa
Jourdanton, TX 78026-1504
Phone (830) 759-5271

499 10TH St
Floresville, TX 78114-3175
Phone (830) 393-1400

7400 Barlite Blvd
San Antonio, TX 78224-1308
Phone (210) 921-2000

Hospital & facility affiliations

  • Methodist Hospital Atascosa Hospital, Jourdanton, TX, CCN 450165

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R179446MDMDRegistered Nurse
215605NCMDRegistered Nurse
26NR12899400NJMDRegistered Nurse
624304NYMDRegistered Nurse
RN564419PAMDRegistered Nurse
825970TXMDCertified Registered Nurse Anesthetist
AP125194TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Koalat Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2022 Accepting new patients
Lone Star Anesthesia Partners PLLC CurrentSince Nov 1, 2023 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2021 Accepting new patients
Anesthesia Associates of Seguin PLLC CurrentSince Aug 25, 2025 Accepting new patients
Sound Physicians Anesthesiology of Texas PLLC CurrentSince Oct 22, 2022 Accepting new patients

Locations

3301 S 14th St
Ste 16180
Abilene, TX 79605

499 10th St
Floresville, TX 78114
Phone (830) 216-7096

1905 E State Highway 97
Jourdanton, TX 78026
Phone (210) 614-9603

2555 Jimmy Johnson Blvd
#O
Port Arthur, TX 77640
Phone (409) 724-7389

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

1310 McCullough Ave
San Antonio, TX 78212
Phone (210) 208-2200

423 Treeline Park
Ste 202
San Antonio, TX 78209
Phone (910) 949-6000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

19010 Stone Oak Pkwy
San Antonio, TX 78258
Phone (210) 575-0355

1215 E Court St
Seguin, TX 78155
Phone (830) 379-2411

Organizations & group practices 5

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": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1013346733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7751 COUGHRAN RD",
            "city": "PLEASANTON",
            "state": "TX",
            "postal_code": "780644435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "570-574-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "RN, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R179446",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR12899400",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "624304",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "215605",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN564419",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "825970",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP125194",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "825970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Ft Sam Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.