Individual provider Active NPI

Clinton Risdon

  • Certified Registered Nurse Anesthetist
  • Lubbock, TX
National Provider Identifier
1245696178
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP129981 Issued in TX
Practice address
3419 22ND St
Lubbock, TX 79410-1334
Phone
(806) 796-3000
Fax
(806) 796-3006
NPI assigned
Jan 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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 AP129981 TX Primary

Addresses

Primary practice location

3419 22ND St
Lubbock, TX 79410-1334

Mailing address

3419 22ND St
Lubbock, TX 79410-1334
Phone (806) 796-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160202001101 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991009508 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endo Sedation LLCGroup PAC ID 4789845363, 289 clinicians
West Texas Digestive Disease Center P.a.Group PAC ID 7416043161, 10 clinicians
Texas Tech University Health Sciences Center LubbockGroup PAC ID 4385549674, 363 clinicians

Practice addresses (Care Compare)

3610 24TH St
Suite B
Lubbock, TX 79410-2014
Phone (806) 797-1015

5115 80TH St
Lubbock, TX 79424-3017
Phone (806) 788-4368

602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 743-2800

Hospital & facility affiliations

  • University Medical Center Hospital, Lubbock, TX, CCN 450686

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP129981TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 2, 2023 Accepting new patients
West Texas Eye PA CurrentSince Jan 1, 2023 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2024 Accepting new patients
West Texas Digestive Disease Center, PA Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2025 Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Apr 1, 2022 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 2, 2023 Accepting new patients
West Texas Eye PA CurrentSince Jan 1, 2023 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
South Plains Pathology Inc Past Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients

Locations

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

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

3610 24th St
Lubbock, TX 79410
Phone (806) 793-3141

3601 4th St
#1B350K
Lubbock, TX 79430
Phone (806) 743-2981

5115 80th St
Lubbock, TX 79424
Phone (806) 788-4368

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

5109 80th St
Lubbock, TX 79424
Phone (806) 792-5900

12210 Quaker Ave
Lubbock, TX 79424
Phone (806) 792-5900

3610 24th St
Ste B
Lubbock, TX 79410
Phone (806) 797-1015

3611 50th St
Lubbock, TX 79413
Phone (806) 792-5900

805 W Wadley Ave
Midland, TX 79705
Phone (806) 792-5900

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

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.

Hospital & facility affiliations 5

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": "1452124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1245696178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 22ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101334",
            "telephone_number": "806-796-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 22ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101334",
            "telephone_number": "806-796-3000",
            "fax_number": "806-796-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISDON",
        "first_name": "CLINTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-07",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP129981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.