Individual provider Active NPI

Susan R. Spence, CRNA

  • Certified Registered Nurse Anesthetist
  • Arlington, TX
National Provider Identifier
1033185467
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
623720 Issued in TX
Practice address
2000 E Lamar Blvd
Suite 400
Arlington, TX 76006-7346
Phone
(682) 227-6834
Fax
(682) 227-6864
NPI assigned
Feb 25, 2006
Last updated
Jan 6, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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 623720 TX Primary

Addresses

Primary practice location

2000 E Lamar Blvd
Suite 400
Arlington, TX 76006-7346

Mailing address

424 Amberwood Cir
Tyler, TX 75701-7016
Phone (318) 572-5292

Other identifiers 3

IdentifierTypeStateIssuer
86211UOtherTXBCBS
181746201MedicaidTX
750818167015OtherTXTRICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060120000383 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214918630 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
623720TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Renaissance Medical Foundation Current Accepting new patients
McAllen Anesthesia Consultants, PA Current Accepting new patients
McAllen Anesthesia Consultants, PA CurrentSince Dec 1, 2021 Accepting new patients
Parish Anesthesia of Monroe, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Willis Knighton Medical Center Inc. Crna Group Nurse Anesthetist, Certified Registered Past Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Clinical Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered PastSince Oct 16, 2022 Accepting new patients

Locations

5501 S McColl Rd
Edinburg, TX 78539
Phone (956) 362-3300

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1140825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262736000000",
    "number": "1033185467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 AMBERWOOD CIR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757017016",
            "telephone_number": "318-572-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E LAMAR BLVD",
            "address_2": "SUITE 400",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760067346",
            "telephone_number": "682-227-6834",
            "fax_number": "682-227-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "SUSAN",
        "middle_name": "R.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-25",
        "last_updated": "2010-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "623720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "86211U",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181746201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "750818167015",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.