Individual provider Active NPI

Robert Edward Brooks, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1164489183
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP126915 Issued in TX
Practice address
6606 LBJ Fwy Ste 200
Dallas, TX 75240-6524
Phone
(972) 233-1999
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X C00309 AR
Certified Registered Nurse Anesthetist 367500000X 72598 OK
Certified Registered Nurse Anesthetist 367500000X APN0000010344 TN
Certified Registered Nurse Anesthetist 367500000X AP126915 TX Primary

Addresses

Primary practice location

6606 LBJ Fwy Ste 200
Dallas, TX 75240-6524

Mailing address

PO Box 840853
Dallas, TX 75284-0853
Phone (972) 715-5000

Other practice location 1

3205 S Crescent Drive
Bryant, AR 72022
Phone (870) 733-4086

Other identifiers 1

IdentifierTypeStateIssuer
115532701MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
72598OKMDCertified Registered Nurse Anesthetist
APN0000010344TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Partners PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Southwestern Physician Services LLC Past Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. PastSince Feb 21, 2018 Accepting new patients
Midstate Medical Services PA PastSince Aug 7, 2012 Accepting new patients
Trident Anesthesia Group, LLC Past Accepting new patients
Arkansas Red Anesthesia Nurse Anesthetist, Certified Registered PastSince Jan 1, 2012 Accepting new patients
Barbara Lazerus Crna Ms Past Accepting new patients
Crittenden Hospital Association Past Accepting new patients
Mobile Anesthesia, LLC Past Accepting new patients
Kentucky Anesthesia Group, PSC Nurse Anesthetist, Certified Registered Past Accepting new patients
Jonesboro Anesthesia Inc Past Accepting new patients

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1164489183",
    "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": "972-715-5000",
            "fax_number": "972-715-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6606 LBJ FWY STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406524",
            "telephone_number": "972-233-1999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3205 S CRESCENT DRIVE",
            "address_purpose": "LOCATION",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "72022",
            "country_code": "US",
            "telephone_number": "870-733-4086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "ROBERT",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C00309",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "72598",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN0000010344",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP126915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115532701",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.