Individual provider Active NPI

Kimberly Malley, CRNA

  • Certified Registered Nurse Anesthetist
  • Mineral Wells, TX
National Provider Identifier
1417907668
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
533994 Issued in TX
Practice address
400 SW 25TH Ave
Mineral Wells, TX 76067-8246
Phone
(940) 325-7891
Fax
(940) 328-6523
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 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 533994 TX Primary

Addresses

Primary practice location

400 SW 25TH Ave
Mineral Wells, TX 76067-8246

Mailing address

400 SW 25TH Ave
Mineral Wells, TX 76067-8246
Phone (940) 325-7891

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040928000170 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547239592 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology Consultants of North Texas PAGroup PAC ID 3870483001, 13 clinicians

Practice addresses (Care Compare)

1021 Holden St
Glen Rose, TX 76043-4937
Phone (254) 897-2215

Hospital & facility affiliations

  • Glen Rose Medical Center Hospital, Glen Rose, TX, CCN 450451

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Palo Pinto County Hospital District Current Accepting new patients
Anesthesiology Consultants of North Texas PA Nurse Anesthetist, Certified Registered CurrentSince Jan 24, 2016 Accepting new patients
Reliance Anesthesia Group, PLLC CurrentSince Mar 21, 2020 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2020 Accepting new patients
Palo Pinto County Hospital District Current Accepting new patients
Palo Pinto County Hospital District Nurse Anesthetist, Certified Registered CurrentSince Jan 14, 2004 Accepting new patients
Palo Pinto County Hospital District CurrentSince Jan 14, 2004 Accepting new patients
Texas Anesthesia Partners, PLLC Past Accepting new patients

Locations

16415 Addison Rd
Addison, TX 75001
Phone (214) 414-3806

17051 Dallas Pkwy
Ste 100
Addison, TX 75001
Phone (469) 718-5260

700 Highlander Blvd
Ste 415
Arlington, TX 76015
Phone (817) 330-1102

6311 Southwest Blvd
Benbrook, TX 76132
Phone (817) 731-9400

1601 W 11th Pl
Big Spring, TX 79720
Phone (432) 263-1211

731 Plaza Blvd
Coppell, TX 75019
Phone (469) 451-5700

1021 Holden St
Glen Rose, TX 76043
Phone (254) 897-1425

2600 W Pleasant Run Rd
Lancaster, TX 75146
Phone (469) 297-5321

400 SW 25th Ave
Mineral Wells, TX 76067
Phone (940) 325-7891

2301 Marsh Ln
Plano, TX 75093
Phone (972) 428-1600

1305 Wonder World Dr
Ste 105
San Marcos, TX 78666
Phone (512) 353-8161

421 E State Highway 114
Southlake, TX 76092
Phone (817) 865-4400

Organizations & group practices 8

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417907668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SW 25TH AVE",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760678246",
            "telephone_number": "940-325-7891",
            "fax_number": "940-328-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SW 25TH AVE",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760678246",
            "telephone_number": "940-325-7891",
            "fax_number": "940-328-6523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLEY",
        "first_name": "KIMBERLY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "533994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineral Wells, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.