Casey Glisson
Individual provider Active NPI Certified Registered Nurse Anesthetist · Maynard, AR
NPI 1336714633 · NPPES record last updated Oct 24, 2023
Key facts
- NPI
- 1336714633
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 1099358 (TX)
- Practice address
- 13502 Highway 115 N
Maynard, AR 72444-0325 - Phone
- (810) 870-3556
- NPI assigned
- May 20, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Premier Anesthesia of Huntsville a Division of Premier Anesthesia LLC
Practice addresses (Care Compare)
1102 W Trenton Rd
Edinburg, TX 78539-9105
Phone (956) 388-6000
1401 E 8TH St
Weslaco, TX 78596-6640
Phone (956) 968-8567
1900 S D St
McAllen, TX 78503-1507
Phone (956) 994-2000
Hospital & facility affiliations
- South Texas Health System
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231010004151 | TX | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 4183079239 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R103778 | AR | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Anesthesia of Huntsville a Division of Premier Anesthesia LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
Locations
5501 S Expressway 77
Harlingen, TX 78550
Phone (936) 569-9481
1401 E 8th St
Weslaco, TX 78596
Phone (956) 581-0303
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 1099358 | TX | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X | R103778 | AR |
Addresses
Primary practice location
13502 Highway 115 N
Maynard, AR 72444-0325
Mailing address
PO Box 325
Maynard, AR 72444-0325
Phone (810) 870-3556
Other providers in Maynard, AR
All providers in Maynard, AR · Certified Registered Nurse Anesthetist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.