Individual provider Active NPI

Jeffrey D. Weertman, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
National Provider Identifier
1487631685
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
640445 Issued in TX
Practice address
6501 Harris Parkway
Fort Worth, TX 76123-2122
Phone
(817) 346-3800
NPI assigned
Dec 28, 2005
Last updated
Jan 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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 640445 TX Primary

Addresses

Primary practice location

6501 Harris Parkway
Fort Worth, TX 76123-2122

Mailing address

2309 Forest Park Cir
Mansfield, TX 76063-7643
Phone (817) 473-1329

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041209000531 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557327681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clearwater Anesthesia PLLCGroup PAC ID 1759347875, 3 clinicians

Practice addresses (Care Compare)

6551 Harris Pkwy
Suite 100
Fort Worth, TX 76132-6105
Phone (817) 346-3800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clearwater Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2004 Accepting new patients
Cityview Surgery Center LLC CurrentSince May 7, 2024 Accepting new patients
Apex Anesthesia Consultants, PLLC Past Accepting new patients
Sundance Anesthesia PA Past Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3301 S 14th St
Ste 16180
Abilene, TX 79605

209 Saint Louis Ave
Fort Worth, TX 76104
Phone (214) 287-2886

6551 Harris Pkwy
Ste 100
Fort Worth, TX 76132
Phone (817) 346-3800

2001 Cooper St
Ft Worth, TX 76104
Phone (817) 334-0990

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1487631685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 FOREST PARK CIR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637643",
            "telephone_number": "817-473-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 HARRIS PARKWAY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761232122",
            "telephone_number": "817-346-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEERTMAN",
        "first_name": "JEFFREY",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "640445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; 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.

Verify at the official NPI Registry.