Active NPI
Kenneth Wray Walcott, CRNA
- Certified Registered Nurse Anesthetist
- Arlington, TX
National Provider Identifier
1467534719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 238600
- Practice address
- 1807 W Park Row Dr
Arlington, TX 76013-3585 - Phone
- (817) 299-9105
- Fax
- (817) 299-8845
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 238600 | TX | Primary |
Addresses
Primary practice location
1807 W Park Row Dr
Arlington, TX 76013-3585
Mailing address
PO Box 173503
Arlington, TX 76003-3503
Phone (817) 299-9105
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 238600 | Other | TX | LIC # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 238600 | TX | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1467534719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 173503",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760033503",
"telephone_number": "817-299-9105",
"fax_number": "817-299-8845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1807 W PARK ROW DR",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760133585",
"telephone_number": "817-299-9105",
"fax_number": "817-299-8845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALCOTT",
"first_name": "KENNETH",
"middle_name": "WRAY",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "238600",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIC #",
"identifier": "238600",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arlington, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.