Individual provider Active NPI

Jeffery W Carroll, CRNA

  • Certified Registered Nurse Anesthetist
  • Harlingen, TX
National Provider Identifier
1295077279
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
631332 Issued in TX
Practice address
2101 Pease St
Harlingen, TX 78550-8307
Phone
(956) 389-1100
Fax
(956) 389-1800
NPI assigned
Mar 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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 631332 TX Primary

Addresses

Primary practice location

2101 Pease St
Harlingen, TX 78550-8307

Mailing address

1702 N Ed Carey Dr
Harlingen, TX 78550-8202
Phone (956) 423-4589

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130509000194 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456598556 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Practice addresses (Care Compare)

5950 Saratoga Blvd
Corpus Christi, TX 78414-4100
Phone (361) 985-5000

600 Elizabeth St
Christus Spohn Hospital Corpus Christi SH
Corpus Christi, TX 78404-2235
Phone (361) 881-3657

7400 Barlite Blvd
San Antonio, TX 78224-1308
Phone (210) 921-2000

Hospital & facility affiliations

  • Christus Spohn Hospital Corpus Christi Hospital, Corpus Christi, TX, CCN 450046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
631332TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Opcare CurrentSince Dec 28, 2022 Accepting new patients
Harlingen Anesthesia Associates Nurse Anesthetist, Certified Registered CurrentSince Mar 18, 2013 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 19, 2021 Accepting new patients
Harlingen Anesthesia Associates Past Accepting new patients

Locations

700 Highlander Blvd
Ste 415
Arlington, TX 76015
Phone (817) 330-1102

1040 W Jefferson St
Brownsville, TX 78520
Phone (956) 423-4589

2101 Pease St
Harlingen, TX 78550
Phone (956) 369-1100

1702 N Ed Carey Dr
Harlingen, TX 78550
Phone (956) 423-4589

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

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 and National Provider Directory roles.

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": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1295077279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 N ED CAREY DR",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508202",
            "telephone_number": "956-423-4589",
            "fax_number": "956-423-9574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 PEASE ST",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508307",
            "telephone_number": "956-389-1100",
            "fax_number": "956-389-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JEFFERY",
        "middle_name": "W",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-18",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "631332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlingen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.