Individual provider Active NPI

Ryan Austin Davis

  • Certified Registered Nurse Anesthetist
  • Burleson, TX
National Provider Identifier
1033694682
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP140314 Issued in TX
Practice address
11801 South Fwy
Burleson, TX 76028-7021
Phone
(817) 293-9110
NPI assigned
Sep 29, 2018
Last updated
Oct 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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 AP140314 TX Primary
Registered Nurse 163W00000X 850753 TX

Addresses

Primary practice location

11801 South Fwy
Burleson, TX 76028-7021

Mailing address

6225 State Hwy 161 Ste 200
Irving, TX 75038-2241

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190222000313 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0143569970 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCH Professional Care Hospital BasedGroup PAC ID 1557535127, 81 clinicians

Practice addresses (Care Compare)

500 W 4TH St
Odessa, TX 79761-5001
Phone (432) 640-2401

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.41 of 100Reported as group
Quality
72.52
Improvement activities
40
Cost
81.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
850753TXMDRegistered Nurse
AP140314TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
MCH Professional Care Hospital Based CurrentSince Nov 1, 2024 Accepting new patients
Northstar Anesthesia II PA Nurse Anesthetist, Certified Registered CurrentSince Jan 25, 2019 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 20, 2020 Accepting new patients

Locations

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

7101 S Padre Island Dr
Corpus Christi, TX 78412
Phone (361) 761-1400

1275 Marvin Hancock Dr
Jasper, TX 75951
Phone (409) 384-1951

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

1305 Wonder World Dr
Ste 105
San Marcos, TX 78666
Phone (512) 353-8161

Organizations & group practices 3

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": "1538179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1033694682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 STATE HWY 161 STE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 SOUTH FWY",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287021",
            "telephone_number": "817-293-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RYAN",
        "middle_name": "AUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-29",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP140314",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "850753",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.