Russell E Dubose, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

248885 Issued in TX

Practice address

3201 S Water St
Burnet, TX 78611-4510

Phone

(512) 715-3000

Fax

(512) 756-6405

NPI assigned

Jun 5, 2006

Sex

Male

Sole proprietor

No

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.

• Ascension Seton

  • Family Medicine Physician
  • Luling, TX
  • NPI 1215118609
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 9, 2011.

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315526400000",
    "number": "1023057239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1219",
            "city": "BURNET",
            "state": "TX",
            "postal_code": "786117219",
            "telephone_number": "512-715-3000",
            "fax_number": "512-756-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 S WATER ST",
            "city": "BURNET",
            "state": "TX",
            "postal_code": "786114510",
            "telephone_number": "512-715-3000",
            "fax_number": "512-756-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "RUSSELL",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2011-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "248885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PIN - GROUP",
            "identifier": "220520501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN - GROUP",
            "identifier": "00405R",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy Liam Danson, O.D.
• Margaret Sue Dean, PH.D./CCC-A
• Melissa Dodd, CCN, IFNCP, CSNC, CW
• Joel Ray Dow, DO
• Cassandra G Doyal, APN, FNP
• Dungarvin Texas, LLC
• Dungarvin Texas, LLC
• Carie Danielle Fansler, APRN FNP-C
• Joseph Ferguson
• Charles Richard Fox, LAT, ATC

• All providers in Burnet, TX
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; 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.