Individual provider Active NPI

Carolyn Jean Graham, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1053726471
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1042504 Issued in TX
Practice address
12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Phone
(972) 715-5000
Fax
(972) 715-9976
NPI assigned
Jun 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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 43-557269-092 KS
Certified Registered Nurse Anesthetist 367500000X 1042504 TX Primary

Addresses

Primary practice location

12222 Merit Dr Ste 600
Dallas, TX 75251-3294

Mailing address

PO Box 840853
Dallas, TX 75284-0853
Phone (972) 233-1999

Other practice location 1

3901 Rainbow Blvd
Ms1034
Kansas City, KS 66160-8500
Phone (913) 588-3316

Other names 1

  • Carolyn Rodriguez Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211104001512 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 5597982082 Reassigns benefits to 2 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
U S Anesthesia Partners of Texas, PAGroup PAC ID 7315850351, 2,750 clinicians
Endo Sedation LLCGroup PAC ID 4789845363, 289 clinicians

Practice addresses (Care Compare)

12400 Dallas Pkwy
Frisco, TX 75033-4224
Phone (469) 495-2000

3500 Preston Rd
Suite 200
Plano, TX 75093-8644
Phone (972) 985-2300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43-557269-092KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2021 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2021 Accepting new patients
U S Anesthesia Partners of Texas, PA Nurse Anesthetist, Certified Registered CurrentSince Jan 23, 2025 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Anesthetist, Certified Registered CurrentSince Jan 23, 2025 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Meritas Health Corporation Past Accepting new patients

Locations

981 State Highway 121
Ste 2100
Allen, TX 75013
Phone (214) 383-8210

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 361-1844

1001 Surrey Ln
Flower Mound, TX 75022
Phone (817) 337-3671

12400 Dallas Pkwy
Frisco, TX 75033
Phone (469) 495-2000

180 Bear Creek Pkwy
Keller, TX 76248
Phone (817) 337-3671

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

2704 N Galloway Ave
Ste 102
Mesquite, TX 75150
Phone (972) 961-7171

3500 Preston Rd
Ste 200
Plano, TX 75093
Phone (972) 985-2300

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

Organizations & group practices 6

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": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1053726471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12222 MERIT DR STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752513294",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Rainbow Blvd",
            "address_2": "MS1034",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661608500",
            "country_code": "US",
            "telephone_number": "913-588-3316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "CAROLYN",
        "middle_name": "JEAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "43-557269-092",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1042504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "RODRIGUEZ",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.