Individual provider Active NPI

Kelly Nichole Tabbert, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1336571462
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP124986 Issued in TX
Practice address
6606 LBJ Fwy
Suite 200
Dallas, TX 75240
Phone
(972) 715-5000
Fax
(972) 715-9976
NPI assigned
Jul 31, 2013
Last updated
Jun 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 718733 TX
Certified Registered Nurse Anesthetist 367500000X AP124986 TX Primary

Addresses

Primary practice location

6606 LBJ Fwy
Suite 200
Dallas, TX 75240

Mailing address

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

Other identifiers 4

IdentifierTypeStateIssuer
8990UFOtherTXBCBS
P01446023OtherTXRR
329482903MedicaidTX
8852UGOtherTXBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140307001450 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072743228 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endo Sedation LLCGroup PAC ID 4789845363, 289 clinicians
Alliance Anesthesia Associates PLLCGroup PAC ID 4385082890, 4 clinicians

Practice addresses (Care Compare)

900 W Magnolia Ave
Suite 101
Fort Worth, TX 76104-8518
Phone (817) 332-6500

9439 N Beach St
Fort Worth, TX 76244-9059
Phone (817) 442-2020

Merit-based Incentive Payment System (MIPS)

Final score
88.94 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP124986TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
U S Anesthesia Partners of Texas, PA Nurse Anesthetist, Certified Registered CurrentSince Jun 14, 2023 Accepting new patients
Texas Anesthesia Partners, PLLC CurrentSince Apr 30, 2024 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Anesthetist, Certified Registered CurrentSince Jun 14, 2023 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2023 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2023 Accepting new patients
Alliance Anesthesia Associates PLLC CurrentSince Jun 15, 2025 Accepting new patients
Synapse Anesthesia Services PLLC CurrentSince Jan 1, 2024 Accepting new patients
Precision Ambulatory Surgery Center, LLC CurrentSince Jun 15, 2025 Accepting new patients

Locations

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

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 776-3185

7502 Greenville Ave
Dallas, TX 75231
Phone (469) 221-6000

6317 Harris Pkwy
Ste 100
Fort Worth, TX 76132
Phone (817) 332-6500

900 W Magnolia Ave
Ste 101
Fort Worth, TX 76104
Phone (817) 332-6500

9439 N Beach St
Fort Worth, TX 76244
Phone (817) 442-2020

1800 Park Place Ave
Ft Worth, TX 76110
Phone (682) 703-5600

2001 W Rosedale St
Ft Worth, TX 76104
Phone (817) 877-4777

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

781 Lonesome Dove Trl
Ste A
Hurst, TX 76054
Phone (817) 479-7280

701 Tuscan Dr
Ste 100
Irving, TX 75039
Phone (214) 496-1100

180 Bear Creek Pkwy
Keller, TX 76248
Phone (817) 337-3671

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

4401 Booth Calloway Rd
Richland Hls, TX 76180
Phone (817) 255-1000

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

2850 E Highway 114
Trophy Club, TX 76262
Phone (817) 837-4600

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1336571462",
    "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",
            "address_2": "SUITE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75240",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABBERT",
        "first_name": "KELLY",
        "middle_name": "NICHOLE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "718733",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP124986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8990UF",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR",
            "identifier": "P01446023",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "329482903",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8852UG",
            "state": "TX"
        }
    ],
    "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 Jun 30, 2020; 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.