Individual provider Active NPI

Travis J. Reinke, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
National Provider Identifier
1528011962
Registry record updated Jun 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
630282 Issued in TX
Practice address
4916 Overton PLZ
Fort Worth, TX 76109
Phone
(888) 804-3000
Fax
(817) 334-0235
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2018

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 630282 TX Primary

Addresses

Primary practice location

4916 Overton PLZ
Fort Worth, TX 76109

Mailing address

PO Box 840853
Dallas, TX 75284-0853
Phone (972) 233-1999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051104000476 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 5597783886 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
630282TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Valiant Anesthesia Associates, PLLC CurrentSince Jan 15, 2024 Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2006 Accepting new patients
Northstar Anesthesia II PA Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2018 Accepting new patients
Seena Anesthesia PLLC CurrentSince Feb 1, 2016 Accepting new patients
Northstar Anesthesia III PA Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2022 Accepting new patients

Locations

2000 E Lamar Blvd
Ste 400
Arlington, TX 76006
Phone (817) 861-3994

701 E Rendon Crowley Rd
Burleson, TX 76028
Phone (817) 293-9292

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

14850 Quorum Dr
Ste 400
Dallas, TX 75254
Phone (214) 801-1879

3455 Locke Ave
Fort Worth, TX 76107
Phone (214) 284-7106

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529712000000",
    "number": "1528011962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4916 OVERTON PLZ",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76109",
            "telephone_number": "888-804-3000",
            "fax_number": "817-334-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINKE",
        "first_name": "TRAVIS",
        "middle_name": "J.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2018-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "630282",
            "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 Jun 23, 2018; 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.