Individual provider Active NPI

Bryan Smith

  • Certified Registered Nurse Anesthetist
  • Tyler, TX
National Provider Identifier
1366259848
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1190230 Issued in TX
Practice address
800 E Dawson St
Tyler, TX 75701-2036
Phone
(903) 593-8441
NPI assigned
Dec 17, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 878291 TX
Certified Registered Nurse Anesthetist 367500000X 152624 TX
Certified Registered Nurse Anesthetist 367500000X 1190230 TX Primary

Addresses

Primary practice location

800 E Dawson St
Tyler, TX 75701-2036

Mailing address

218 Shahan TRL
Whitehouse, TX 75791-1216

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250214002895 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850821174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 E Dawson St
Tyler, TX 75701-2036

910 E Houston St
Christus Mother Frances Hospital
Tyler, TX 75702-8369
Phone (903) 531-5300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
878291TXMDRegistered Nurse
1190230TXMDCertified Registered Nurse Anesthetist
152624TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mother Frances Hospital Regional Health Care Center CurrentSince Feb 24, 2025 Accepting new patients
Mother Frances Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Organizations & group practices 2

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.

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": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1366259848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 SHAHAN TRL",
            "city": "WHITEHOUSE",
            "state": "TX",
            "postal_code": "757911216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E DAWSON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012036",
            "telephone_number": "903-593-8441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-17",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "878291",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "152624",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1190230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.