Roswell Procedural Medicine Associates

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

CRNA-01308 Issued in NM

Legal business name

ROSWELL PROCEDURAL MEDICINE ASSOCIATES

Doing business as

Southwest Pain Management

Practice address

7451 Chapel Ave
Fort Worth, TX 76116-7090

Phone

(817) 294-7444

Fax

(817) 423-9060

NPI assigned

Aug 14, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Robert Louis Delillo, C.R.N.A., A.R.N.P.

Title

Ceo, Cfo

Phone

(817) 966-2762

Specialties & licenses 2

Addresses

Other identifiers 7

Other names 1

• Southwest Pain Management Doing business as

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407974400000",
    "number": "1366841587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2626",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761132626",
            "telephone_number": "817-294-7444",
            "fax_number": "817-423-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7451 CHAPEL AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167090",
            "telephone_number": "817-294-7444",
            "fax_number": "817-423-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSWELL PROCEDURAL MEDICINE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A",
        "authorized_official_last_name": "DELILLO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "CEO, CFO",
        "authorized_official_telephone_number": "817-966-2762",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.R.N.A., A.R.N.P."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "CRNA-01308",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "514647",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8755UE",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126047304",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI (INDIVIDUAL)",
            "identifier": "1013008721",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS (PERSONAL)",
            "identifier": "84396C",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS (METRO C.R.N.A. SERVICES, INC)",
            "identifier": "00C37J",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006995701 (CORP)",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI (METRO CRNA SERVICES, INC)",
            "identifier": "1245314640",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Pain Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan Ellen Ross, FNP
• Tara Ross, LPC
• Marie Sabine Elisa Rosse Griggs, RBT
• Sydney Rossow
• Whitney Rostis, M.S., CCC-SLP
• Lisa M Roten, MD
• Jessica Ann Roth
• John T. Roth, AU.D.
• Thomas A Rothenbach, M.D.
• Ana L. Rothschild

• Certified Registered Nurse Anesthetist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.