Individual provider Active NPI

John Dempsey Myers II, CRNA

  • Certified Registered Nurse Anesthetist
  • Athens, TX
National Provider Identifier
1467434456
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
237242 Issued in TX
Practice address
510 E Clinton Ave
Athens, TX 75751-3410
Phone
(903) 731-1000
Fax
(903) 677-5586
NPI assigned
Nov 16, 2005
Last updated
Apr 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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 237242 TX Primary

Addresses

Primary practice location

510 E Clinton Ave
Athens, TX 75751-3410

Mailing address

PO Box 270
Athens, TX 75751-0270
Phone (903) 723-2465

Other identifiers 2

IdentifierTypeStateIssuer
1347825-05MedicaidTX
1347825-04MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100810000429 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709910912 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2021 Accepting new patients
Anderson County Anesthesia Associates, PA 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

125 Newman St
Fairfield, TX 75840
Phone (888) 250-2326

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

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

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1467434456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757510270",
            "telephone_number": "903-723-2465",
            "fax_number": "903-677-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E CLINTON AVE",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757513410",
            "telephone_number": "903-731-1000",
            "fax_number": "903-677-5586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "JOHN",
        "middle_name": "DEMPSEY",
        "name_suffix": "II",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "237242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1347825-05",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1347825-04",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.