Individual provider Active NPI

Roy L Sturdivant, CRNA

  • Certified Registered Nurse Anesthetist
  • Texarkana, TX
National Provider Identifier
1316945199
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
244867 Issued in TX
Practice address
4500 Summerhill Rd
Texarkana, TX 75503-2740
Phone
(903) 792-8888
Fax
(903) 792-8984
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 244867 TX Primary

Addresses

Primary practice location

4500 Summerhill Rd
Texarkana, TX 75503-2740

Mailing address

4500 Summerhill Rd
Texarkana, TX 75503-2740
Phone (903) 792-8888

Other identifiers 2

IdentifierTypeStateIssuer
97082OtherARBLUE CROSS
84294COtherTXBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040312000285 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648169284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texarkana Gastroenterology Consultants, PAGroup PAC ID 0345212817, 18 clinicians

Practice addresses (Care Compare)

1920 Moores LN
Suite a
Texarkana, TX 75503-4660
Phone 90379280302080

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38748TXMDPsychologist
244867TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Texarkana Gastroenterology Consultants, PA CurrentSince Jan 26, 2011 Accepting new patients
Collom & Carney Clinic Association Current Accepting new patients
Independent Anesthesia of Texarkana, L.L.P Past Accepting new patients
Medical Center Medical Group Past Accepting new patients
Anesthesia and Intensive Care Past Accepting new patients

Locations

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

1920 Moores Ln
Ste A
Texarkana, TX 75503
Phone (903) 792-8030

5002 Cowhorn Creek Rd
Texarkana, TX 75503
Phone (903) 614-3008

Interoperability endpoints

  • Direct secure messaging: roy.sturdivant.p1@direct.collom-carney.nextgenshare.com
  • FHIR API: https://ab0ad0d3-1a1d-47a7-80b0-c0bd276b844e.gastro.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 5

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1316945199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SUMMERHILL RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032740",
            "telephone_number": "903-792-8888",
            "fax_number": "903-792-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SUMMERHILL RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032740",
            "telephone_number": "903-792-8888",
            "fax_number": "903-792-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURDIVANT",
        "first_name": "ROY",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "244867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "97082",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "84294C",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.