Individual provider Active NPI

Kristen Marie Petersen, CRNA

  • Certified Registered Nurse Anesthetist
  • Richardson, TX
National Provider Identifier
1467692905
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
705741 Issued in TX
Practice address
339 Ridgebriar Dr
Richardson, TX 75080-1920
Phone
(214) 244-1756
NPI assigned
Feb 24, 2009
Last updated
Sep 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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 705741 TX Primary

Addresses

Primary practice location

339 Ridgebriar Dr
Richardson, TX 75080-1920

Mailing address

13488 Thornton Dr
Frisco, TX 75035-7393
Phone (214) 244-1756

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090512000334 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800945304 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
705741TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Anesthesia Partners, PLLC CurrentSince Aug 1, 2021 Accepting new patients
Orthomed Staffing LLC CurrentSince Jun 30, 2021 Accepting new patients
Reliance Anesthesia Group, PLLC CurrentSince Feb 16, 2021 Accepting new patients
Vertex Anesthesia, PLLC CurrentSince Mar 4, 2017 Accepting new patients
Anesthesiology Consultants of North Texas PA Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2020 Accepting new patients
Assured Anesthesia Consultants, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations (25 of 30)

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

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

1105 Central Expy N
Ste 210
Allen, TX 75013
Phone (972) 747-4646

1105 Central Expy N
Ste 380
Allen, TX 75013
Phone (972) 747-5840

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

1401 E Trinity Mills Rd
Carrollton, TX 75006
Phone (972) 810-0700

12230 Coit Rd
Ste 200
Dallas, TX 75251
Phone (469) 374-6400

2727 E Lemmon Ave
Dallas, TX 75204
Phone (214) 443-3000

7502 Greenville Ave
Dallas, TX 75231
Phone (469) 221-6000

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

9440 Poppy Dr
Dallas, TX 75218
Phone (214) 324-6100

7 Medical Pkwy
Farmers Brnch, TX 75234
Phone (972) 247-1000

5500 Frisco Square Blvd
Frisco, TX 75034
Phone (214) 618-0500

1800 Park Place Ave
Ft Worth, TX 76110
Phone (682) 703-5600

2300 Marie Curie Dr
Garland, TX 75042
Phone (972) 487-5000

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

7010 Champions Plaza Dr
Ste 300
Houston, TX 77069
Phone (832) 698-5320

400 W Lyndon B Johnson Fwy
Ste 101
Irving, TX 75063
Phone (972) 868-4000

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

8000 Eldorado Pkwy
McKinney, TX 75070
Phone (469) 424-6400

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

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

4100 Mapleshade Ln
Plano, TX 75093
Phone (917) 216-6285

4700 Alliance Blvd
Plano, TX 75093
Phone (469) 814-2000

4708 Alliance Blvd
Ste 210
Plano, TX 75093
Phone (469) 800-6021

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, 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": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1467692905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13488 THORNTON DR",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750357393",
            "telephone_number": "214-244-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 RIDGEBRIAR DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750801920",
            "telephone_number": "214-244-1756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-24",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "705741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.