NPIMap

Organization Active NPI

Clearwater Anesthesia PLLC

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
National Provider Identifier
1538170485
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
CLEARWATER ANESTHESIA PLLC
Practice address
6551 Harris Pkwy
Suite 100
Fort Worth, TX 76132-6103
Phone
(817) 346-3800
NPI assigned
Aug 10, 2006
Last updated
Jan 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Authorized official

Name
Jeff T Weertman, CRNA
Title
Manager
Phone
(817) 723-9174

Specialties & licenses 1

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

Addresses

Primary practice location

6551 Harris Pkwy
Suite 100
Fort Worth, TX 76132-6103

Mailing address

3301 S 14TH St Ste 16180
Abilene, TX 79605-5015
Phone (325) 660-5535

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041209000483 TX Part B Supplier - Clinic/Group Practice 1759347875 Receives reassigned benefits from 9 practitioners
Practice locations: Fort Worth, TX; Southlake, TX

National Provider Directory

National Provider Directory

Locations

1651 W Rosedale St
Fort Worth, TX 76104
Phone (817) 257-4212

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

3712 W 7th St
#A
Fort Worth, TX 76107

1980 E State Highway 114
Southlake, TX 76092
Phone (817) 329-2700

Practitioners & affiliated clinicians

Practitioners 10

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": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610409600000",
    "number": "1538170485",
    "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": "325-660-5535",
            "fax_number": "325-692-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6551 HARRIS PKWY",
            "address_2": "SUITE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761326103",
            "telephone_number": "817-346-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATER ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A",
        "authorized_official_last_name": "WEERTMAN",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "817-723-9174",
        "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 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 12, 2021; 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.