NPIMap

Organization Active NPI

Royal Anesthesia Inc.

  • Certified Registered Nurse Anesthetist
  • Tyler, TX
National Provider Identifier
1477164440
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
ROYAL ANESTHESIA INC.
Practice address
2448 E 5TH St
Tyler, TX 75701-3525
Phone
(903) 535-3000
NPI assigned
Aug 13, 2020
Last updated
Jun 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jody King, CRNANPI 1235281114
Title
President
Phone
(903) 574-2127

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

2448 E 5TH St
Tyler, TX 75701-3525

Mailing address

3131 County Road 3707
Bullard, TX 75757-5595
Phone (903) 574-2127

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200821000278 TX Part B Supplier - Clinic/Group Practice 5890111892 Receives reassigned benefits from 2 practitioners
Practice locations: Longview, TX; Tyler, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1477164440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 COUNTY ROAD 3707",
            "city": "BULLARD",
            "state": "TX",
            "postal_code": "757575595",
            "telephone_number": "903-574-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2448 E 5TH ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013525",
            "telephone_number": "903-535-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROYAL ANESTHESIA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-13",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "JODY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-574-2127",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.