NPIMap

Individual provider Active NPI

Robert Walden, CRNA

  • Registered Nurse
  • Houston, TX
National Provider Identifier
1407252273
Registry record updated Nov 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
8667910 Issued in TX
Practice address
1002 Gemini St
Suite 128
Houston, TX 77058-2746
Phone
(281) 218-9515
Fax
(281) 218-9534
NPI assigned
Nov 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 8667910 TX Primary

Addresses

Primary practice location

1002 Gemini St
Suite 128
Houston, TX 77058-2746

Mailing address

1002 Gemini St
Suite 128
Houston, TX 77058-2746
Phone (281) 218-9515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170328000775 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012231640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1801 16TH St
Greeley, CO 80631-5154
Phone (970) 810-4121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8667910TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain State Anesthesia Providers CurrentSince Mar 1, 2018 Accepting new patients
Rocky Mountain State Anesthesia Providers CurrentSince Mar 1, 2018 Accepting new patients

Locations

4700 Lady Moon Dr
Fort Collins, CO 80528
Phone (970) 521-4600

5890 W 13th St
Ste 102
Greeley, CO 80634
Phone (970) 348-0090

5890 W 13th St
Greeley, CO 80634
Phone (970) 356-4567

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

2000 Boise Ave
Loveland, CO 80538
Phone (970) 635-4071

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 12

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": "1415232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1407252273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 GEMINI ST",
            "address_2": "SUITE 128",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582746",
            "telephone_number": "281-218-9515",
            "fax_number": "281-218-9534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 GEMINI ST",
            "address_2": "SUITE 128",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582746",
            "telephone_number": "281-218-9515",
            "fax_number": "281-218-9534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDEN",
        "first_name": "ROBERT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-06",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "8667910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; 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.