Organization Active NPI

Mac-Bar Anesthesia PLLC

  • Certified Registered Nurse Anesthetist
  • Abilene, TX
National Provider Identifier
1366809295
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
MAC-BAR ANESTHESIA PLLC
Practice address
2120 Antilley Rd
Abilene, TX 79606-5211
Phone
(325) 675-6466
NPI assigned
Jan 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Authorized official

Name
Dr. Amber Dawn Ponder, DNAP, CRNANPI 1942448808
Title
Ceo
Phone
(325) 675-6466

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

2120 Antilley Rd
Abilene, TX 79606-5211

Mailing address

2438 Industrial Blvd
PMB 166
Abilene, TX 79605-7207
Phone (325) 675-6466

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160328000729 TX Part B Supplier - Clinic/Group Practice 4587961115 Receives reassigned benefits from 1 practitioner
Practice locations: Abilene, TX

National Provider Directory

National Provider Directory

Locations

2438 Industrial Blvd
Abilene, TX 79605
Phone (325) 514-3869

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1453420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653609600000",
    "number": "1366809295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2438 INDUSTRIAL BLVD",
            "address_2": "PMB 166",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796057207",
            "telephone_number": "325-675-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 ANTILLEY RD",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065211",
            "telephone_number": "325-675-6466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAC-BAR ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-22",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A",
        "authorized_official_last_name": "PONDER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "325-675-6466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNAP, CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.