Individual provider Active NPI

Robert Ryan Pettit, CRNA

  • Certified Registered Nurse Anesthetist
  • Tyler, TX
National Provider Identifier
1386001634
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP129992 Issued in TX
Practice address
800 E Dawson St
Tyler, TX 75701-2036
Phone
(903) 531-4522
NPI assigned
Jan 18, 2016
Last updated
Apr 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP129992 TX Primary

Addresses

Primary practice location

800 E Dawson St
Tyler, TX 75701-2036

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 606-6400

Other practice location 1

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4600

Other practice location 2

2001 N Jefferson Ave
Mount Pleasant, TX 75455-2338
Phone (903) 577-6000

Other identifiers 3

IdentifierTypeStateIssuer
75-0818167-015OtherTXTRICARE
354942004MedicaidTX
P01769553OtherTXRAIL ROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160314001946 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163728304 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians
Titus County Hospital DistrictGroup PAC ID 0143203257, 107 clinicians
Mother Frances Hospital JacksonvilleGroup PAC ID 5597751024, 30 clinicians

Practice addresses (Care Compare)

1000 S Beckham Ave
Tyler, TX 75701-1908
Phone (903) 747-4586

2001 N Jefferson Ave
Mount Pleasant, TX 75455-2338
Phone (903) 577-6000

2010 S Jackson St
Christus Mother Frances Hospital Jacksonvil
Jacksonville, TX 75766-5822
Phone (903) 541-4548

2026 S Jackson St
Jacksonville, TX 75766-5822

7400 Barlite Blvd
San Antonio, TX 78224-1308
Phone (210) 921-2000

800 E Dawson St
Tyler, TX 75701-2036

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP129992TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Titus County Hospital District CurrentSince Oct 1, 2024 Accepting new patients
Northstar Anesthesia III PA Nurse Anesthetist, Certified Registered CurrentSince Jul 11, 2022 Accepting new patients
MCH Professional Care Hospital Based CurrentSince Oct 18, 2023 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 3, 2025 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Aug 8, 2016 Accepting new patients
Titus County Hospital District CurrentSince Oct 1, 2024 Accepting new patients
Mother Frances Hospital Jacksonville Nurse Anesthetist, Certified Registered CurrentSince Aug 14, 2023 Accepting new patients
Titus County Hospital District Past Accepting new patients
Mother Frances Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

14425 Falcon Head Blvd
#11
Austin, TX 78738
Phone (512) 900-1006

3080 College St
#T
Beaumont, TX 77701
Phone (409) 212-5002

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

6949 Bryant Irvin Rd
Ste 110
Ft Worth, TX 76132
Phone (817) 332-1818

6800 N MacArthur Blvd
Irving, TX 75039
Phone (972) 969-2000

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

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

2001 N Jefferson Ave
Mt Pleasant, TX 75455
Phone (903) 434-8044

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

4600 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (713) 853-9302

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

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

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1453075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1386001634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-606-6400"
        },
        {
            "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": "903-531-4522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2026 S Jackson St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "TX",
            "postal_code": "75766",
            "country_code": "US",
            "telephone_number": "903-541-4600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 N Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "TX",
            "postal_code": "754552338",
            "country_code": "US",
            "telephone_number": "903-577-6000",
            "fax_number": "903-577-6245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "ROBERT",
        "middle_name": "RYAN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-18",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP129992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-015",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "354942004",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P01769553",
            "state": "TX"
        }
    ],
    "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 Apr 27, 2026; 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.