Brent Andrew Hathcock, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

616833 Issued in TX

Practice address

6606 LBJ Fwy
Ste 200
Dallas, TX 75240

Phone

(972) 715-5000

Fax

(972) 715-9976

NPI assigned

Dec 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• General Anesthesia Services, PLLC

  • Anesthesiology Physician
  • Irving, TX
  • NPI 1326410978
  Medicare reassignment NPD
• Noble Anesthesia Partners, PLLC

  • Anesthesiology Physician
  • Irving, TX
  • NPI 1619259553
  Medicare reassignment NPD
• John Peter Smith Hospital

  • Psychiatric Hospital
  • Fort Worth, TX
  • NPI 1760642177
  NPD (past)
• Sheridan Healthcare of North Texas PA

  • Anesthesiology Physician
  • Sunrise, FL
  • NPI 1538142088
  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1104803402",
    "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": "6606 LBJ FWY",
            "address_2": "STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75240",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHCOCK",
        "first_name": "BRENT",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "616833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00128435",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "83823U",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157756103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deja Malisia Hatcher
• Mojgan Hateminejad, RN
• Blake D Hatfield, M.D.
• Maureen Hatfield
• Lorien Hathaway
• Charli Hathcock, DNP, FNP-BC
• Sumitha Sukumar Hathiramani, MD
• Lydia Vincent Hathorn, MSN, RN, WHNP-BC
• William A Hathorn, CRNA
• Amanda Genry Hatley

• Certified Registered Nurse Anesthetist in Dallas, TX
• Providers in Dallas, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.