Active NPI
Jeremy Blake Eaves, CRNA
- Certified Registered Nurse Anesthetist
- Fort Worth, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 1177067
- Practice address
- 1301 Pennsylvania Ave
Fort Worth, TX 76104-2122 - Phone
- (817) 250-2000
- NPI assigned
- Jul 24, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 915308 | TX | |
| Certified Registered Nurse Anesthetist | 367500000X | 1177067 | TX | Primary |
Addresses
Primary practice location
1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Mailing address
PO Box 840853
Dallas, TX 75284-2087
Phone (972) 233-1999
Other practice location 1
12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Phone (972) 715-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone (817) 878-5500
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 915308 | TX | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| U S Anesthesia Partners of Texas, PA | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| U. S. Anesthesia Partners of Texas, P.a., | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 361-1844
1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000
1800 Park Place Ave
Ft Worth, TX 76110
Phone (682) 703-5600
100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555
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.
-
dba Greater Houston Anesthesiology, P.A.
- Anesthesiology Physician
- Houston, TX
- NPI 1548208564
Nurse Anesthetist, Certified Registered
-
- Interventional Pain Medicine Physician
- Addison, TX
- NPI 1053800391
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Worth, TX
- NPI 1336172105
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731542400000",
"number": "1467280008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 840853",
"city": "DALLAS",
"state": "TX",
"postal_code": "752842087",
"telephone_number": "972-233-1999",
"fax_number": "972-233-3666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 PENNSYLVANIA AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761042122",
"telephone_number": "817-250-2000"
}
],
"practiceLocations": [
{
"address_1": "12222 Merit Dr Ste 600",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752513294",
"country_code": "US",
"telephone_number": "972-715-5000",
"fax_number": "972-715-9976",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EAVES",
"first_name": "JEREMY",
"middle_name": "BLAKE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-24",
"last_updated": "2024-11-14",
"certification_date": "2024-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TX",
"license": "915308",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "1177067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.