NPIMap

Organization Active NPI

Metroplex Adventist Hospital Crna Inc

  • Anesthesiology Physician
  • Killeen, TX
National Provider Identifier
1306035944
Registry record updated Oct 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
METROPLEX ADVENTIST HOSPITAL CRNA INC
Practice address
2201 S Clear Creek Rd
Killeen, TX 76549-4110
Phone
(254) 519-8165
NPI assigned
Oct 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2008

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

Authorized official

Name
Penny L Johnson
Title
Vice President/Cfo
Phone
(254) 519-8165

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 367500000X

Addresses

Primary practice location

2201 S Clear Creek Rd
Killeen, TX 76549-4110

Mailing address

PO Box 938
Killeen, TX 76540-0938
Phone (254) 634-6999

Other identifiers 2

IdentifierTypeStateIssuer
193418401MedicaidTX
00C91VOtherTXBCBS OF TEXAS

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1306035944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 938",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765400938",
            "telephone_number": "254-634-6999",
            "fax_number": "254-200-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 S CLEAR CREEK RD",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494110",
            "telephone_number": "254-519-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPLEX ADVENTIST HOSPITAL CRNA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "PENNY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE PRESIDENT/CFO",
        "authorized_official_telephone_number": "254-519-8165"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193418401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "00C91V",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; 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.