NPIMap

Organization Active NPI

Enterprise Anesthesia Services, PLLC

  • Certified Registered Nurse Anesthetist
  • Abilene, TX
National Provider Identifier
1528178019
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
595335 Issued in TX
Legal business name
ENTERPRISE ANESTHESIA SERVICES, PLLC
Practice address
5602 Health Center Dr
Abilene, TX 79606-1227
Phone
(325) 793-3755
Fax
(325) 793-3750
NPI assigned
Aug 30, 2006
Last updated
Dec 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Authorized official

Name
Poppy A Walker, MBA
Title
Practice Administrator
Phone
(325) 675-6466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 595335 TX Primary

Addresses

Primary practice location

5602 Health Center Dr
Abilene, TX 79606-1227

Mailing address

3301 S 14TH St Ste 16180
Abilene, TX 79605-5015
Phone (325) 675-6466

Other practice location 1

720 Hospital Dr
Andrews, TX 79714-3617
Phone (325) 675-6466 ext. 2

Other identifiers 3

IdentifierTypeStateIssuer
DD3524OtherTXRR MEDICARE GROUP #
00C44SOtherTXBCBS GROUP #
170450401MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041110000358 TX Part B Supplier - Clinic/Group Practice 7315900347 Receives reassigned benefits from 5 practitioners
Practice locations: Andrews, TX; Abilene, TX

National Provider Directory

National Provider Directory

Locations

3301 S 14th St
#16180
Abilene, TX 79605

Practitioners & affiliated clinicians

Practitioners 5

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": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701734400000",
    "number": "1528178019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 S 14TH ST STE 16180",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796055015",
            "telephone_number": "325-675-6466",
            "fax_number": "325-692-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5602 HEALTH CENTER DR",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796061227",
            "telephone_number": "325-793-3755",
            "fax_number": "325-793-3750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Andrews",
            "state": "TX",
            "postal_code": "797143617",
            "country_code": "US",
            "telephone_number": "325-675-6466 x2",
            "fax_number": "325-692-6030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ENTERPRISE ANESTHESIA SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "POPPY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "325-675-6466",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "595335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP #",
            "identifier": "DD3524",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "00C44S",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170450401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.