Individual provider Active NPI

Ryan P Fontenot, CRNA

  • Certified Registered Nurse Anesthetist
  • Brenham, TX
National Provider Identifier
1104156546
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP119221 Issued in TX
Practice address
700 Medical Pkwy
Brenham, TX 77833-5413
Phone
(979) 337-5000
NPI assigned
Jan 7, 2010
Last updated
Aug 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 789090 TX
Certified Registered Nurse Anesthetist 367500000X RN103850 LA
Certified Registered Nurse Anesthetist 367500000X AP119221 TX Primary

Addresses

Primary practice location

700 Medical Pkwy
Brenham, TX 77833-5413

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other practice location 1

1500 Citywest Blvd Ste 300
Houston, TX 77042-2549
Phone (713) 620-4000

Other practice location 2

6606 Lbj Fwy Ste 200
Dallas, TX 75240-6524
Phone (972) 715-5000

Other practice location 3

2411 Fountain View Dr
Ste. 200
Houston, TX 77057-4817
Phone (713) 620-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rfontenot1106288@direct.sw.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100921001077 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901933019 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1280 Arrington Rd
Suite 200
College Station, TX 77845-8696
Phone (979) 207-6550

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

1700 University Dr E
College Station, TX 77840-2661
Phone (979) 691-3300

1700 University Dr E Entrance 16
Care Clinic College Station University Dr
College Station, TX 77840-2661
Phone (979) 207-3636

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

700 Medical Pkwy
Brenham, TX 77833-5413
Phone (979) 836-6173

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
789090TXMDCertified Registered Nurse Anesthetist
AP119221TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Current Accepting new patients
Scott & White Clinic CurrentSince Jul 15, 2022 Accepting new patients
Scott & White Clinic CurrentSince Jul 15, 2022 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

700 Medical Pkwy
Brenham, TX 77833
Phone (979) 337-5000

1280 Arrington Rd
Ste 200
College Station, TX 77845
Phone (979) 207-6550

700 Scott and White Dr
College Station, TX 77845
Phone (979) 207-0100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100

Interoperability endpoints

  • Direct secure messaging: rfontenot1106288@direct.sw.org

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 1

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": "1262822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1104156546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MEDICAL PKWY",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778335413",
            "telephone_number": "979-337-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Citywest Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770422549",
            "country_code": "US",
            "telephone_number": "713-620-4000",
            "fax_number": "713-458-4229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6606 Lbj Fwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752406524",
            "country_code": "US",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2411 Fountain View Dr",
            "address_2": "Ste. 200",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770574817",
            "country_code": "US",
            "telephone_number": "713-620-4000",
            "fax_number": "713-458-4229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "RYAN",
        "middle_name": "P",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-07",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "789090",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN103850",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP119221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rfontenot1106288@direct.sw.org",
            "affiliation": "N",
            "address_1": "700 Medical Pkwy",
            "city": "Brenham",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778335413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.