Individual provider Active NPI

Robert D Coleman, CRNA

  • Certified Registered Nurse Anesthetist
  • Port Lavaca, TX
National Provider Identifier
1083658546
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
52733 Issued in TX
Practice address
815 N Virginia St
Port Lavaca, TX 77979
Phone
(361) 573-6291
Fax
(361) 576-2434
NPI assigned
Jun 15, 2006
Last updated
Aug 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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 52733 TX Primary

Addresses

Primary practice location

815 N Virginia St
Port Lavaca, TX 77979

Mailing address

1501 E Mockingbird LN Ste 101
Victoria, TX 77904-2178
Phone (361) 573-6291

Other identifiers 1

IdentifierTypeStateIssuer
165728002MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040415000200 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769477348 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52733TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of Huntsville a Division of Premier Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 9, 2021 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2020 Accepting new patients
Florida Gulf-to-Bay Anesthesiology Associates, LLC Past Accepting new patients
Gulf Shore Anesthesia Associates PA Past Accepting new patients

Locations

5950 Saratoga Blvd
Corpus Christi, TX 78414
Phone (361) 985-5000

600 Elizabeth St
Ste 605
Corpus Christi, TX 78404

5501 S Expressway 77
Harlingen, TX 78550
Phone (936) 569-9481

1900 S D St
McAllen, TX 78503
Phone (956) 994-2000

301 W Expressway 83
McAllen, TX 78503
Phone (956) 467-9552

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

1401 E 8th St
Weslaco, TX 78596
Phone (956) 581-0303

Organizations & group practices 4

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1083658546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E MOCKINGBIRD LN STE 101",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042178",
            "telephone_number": "361-573-6291",
            "fax_number": "361-576-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 N VIRGINIA ST",
            "city": "PORT LAVACA",
            "state": "TX",
            "postal_code": "77979",
            "telephone_number": "361-573-6291",
            "fax_number": "361-576-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "ROBERT",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "52733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165728002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Lavaca, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.