Individual provider Active NPI

Kaylee Waller, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1356762728
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
742739 Issued in TX
Practice address
14850 Quorum Dr Ste 400
Dallas, TX 75254-1445
Phone
(469) 437-3564
Fax
(469) 825-6903
NPI assigned
Jan 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 100315 TX
Certified Registered Nurse Anesthetist 367500000X 742739 NC
Certified Registered Nurse Anesthetist 367500000X 742739 TX Primary

Addresses

Primary practice location

14850 Quorum Dr Ste 400
Dallas, TX 75254-1445

Mailing address

14850 Quorum Dr Ste 400
Dallas, TX 75254-1445
Phone (469) 437-3564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140602000336 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395968820 Reassigns benefits to 10 organizations
I20160520001083 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395968820 Reassigns benefits to 2 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
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians
Spine Team Texas PAGroup PAC ID 6507888757, 27 clinicians

Practice addresses (Care Compare)

1400 8TH Ave
Fort Worth, TX 76104-4110

1545 E Southlake Blvd
Suite 100
Southlake, TX 76092-6465
Phone (817) 442-9300

5408 Colleyville Blvd
Colleyville, TX 76034-5833
Phone (817) 498-9920

Hospital & facility affiliations

  • Baylor Scott and White All Saints Medical Center Hospital, Fort Worth, TX, CCN 450137

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
742739NCMDCertified Registered Nurse Anesthetist
100315TXMDCertified Registered Nurse Anesthetist
742739TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of Huntsville a Division of Premier Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 14, 2015 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Anesthetist, Certified Registered CurrentSince May 1, 2017 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2017 Accepting new patients
Eagle Anesthesia PLLC CurrentSince Aug 16, 2019 Accepting new patients
Valiant Anesthesia Associates, PLLC CurrentSince Mar 1, 2019 Accepting new patients
Spine Team Texas, PA CurrentSince Dec 1, 2019 Accepting new patients
Spine Team Texas PA Current Accepting new patients
Cook Children'S Physician Network CurrentSince Feb 22, 2014 Accepting new patients
U S Anesthesia Partners of Texas, PA Nurse Anesthetist, Certified Registered CurrentSince May 1, 2017 Accepting new patients
Premier Interventional Pain Management, P.L.L.C CurrentSince Jan 1, 2019 Accepting new patients
Carolina Anesthesia Associates PA Nurse Anesthetist, Certified Registered CurrentSince May 1, 2016 Accepting new patients
Synergy Anesthesia Management CurrentSince Jun 10, 2021 Accepting new patients
Orthomed Staffing LLC CurrentSince Nov 1, 2021 Accepting new patients
Carolina Regional Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2016 Accepting new patients
Cook Children'S Physician Network CurrentSince Feb 22, 2014 Accepting new patients
Spine Team Texas, PA CurrentSince Dec 1, 2019 Accepting new patients
Premier Interventional Pain Management, P.L.L.C CurrentSince Jan 1, 2019 Accepting new patients
Bladen Healthcare LLC Past Accepting new patients
Red River Anesthesiology Group L.L.P. PastSince Nov 16, 2016 Accepting new patients

Locations (25 of 35)

2015 Randolph Rd
Ste 208
Charlotte, NC 28207
Phone (704) 602-6544

1141 N Road St
#1
Elizabeth City, NC 27909
Phone (252) 338-0101

3312 Battleground Ave
Greensboro, NC 27410
Phone (336) 282-5000

5115 Oleander Dr
Wilmington, NC 28403
Phone (910) 362-1011

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

17101 Dallas Pkwy
Addison, TX 75001
Phone (214) 696-8033

801 W Interstate 20
Arlington, TX 76017
Phone (817) 472-3400

920 S Belt Line Rd
Ste 250
Coppell, TX 75019
Phone (469) 307-5111

14850 Quorum Dr
Ste 400
Dallas, TX 75254
Phone (214) 801-1879

2727 E Lemmon Ave
Dallas, TX 75204
Phone (214) 443-3000

7992 W Virginia Dr
Dallas, TX 75237
Phone (214) 283-2400

461 Westpark Way
Euless, TX 76040
Phone (817) 540-1755

7 Medical Pkwy
Farmers Brnch, TX 75234
Phone (972) 247-1000

2321 Olympia Dr
Ste 100A
Flower Mound, TX 75028
Phone (972) 350-0225

8350 Dallas Pkwy
Ste 100
Frisco, TX 75034
Phone (469) 213-8310

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

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

5501 S Expressway 77
Harlingen, TX 78550
Phone (936) 569-9481

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

809 W Harwood Rd
Ste 101
Hurst, TX 76054
Phone (817) 283-5252

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

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

2201 K Ave
Ste B100
Plano, TX 75074
Phone (214) 931-6133

6020 W Parker Rd
Ste 300
Plano, TX 75093
Phone (469) 200-6461

4005 W 15th St
Plano, TX 75093
Phone (214) 250-3531

Organizations & group practices 20

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.

View all 20

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": "1388620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1356762728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14850 QUORUM DR STE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752541445",
            "telephone_number": "469-437-3564",
            "fax_number": "469-825-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14850 QUORUM DR STE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752541445",
            "telephone_number": "469-437-3564",
            "fax_number": "469-825-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "KAYLEE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-02",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "100315",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "742739",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "742739",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 10, 2024; 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.