Susan M. Willis, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP101864 Issued in TX

Practice address

7205 Lake Mead Blvd
Arlington, TX 76016-4137

Phone

(817) 563-9211

NPI assigned

Jul 14, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

U S Anesthesia Partners of Texas, PAGroup PAC ID 7315850351, 2,750 clinicians

Endo Sedation LLCGroup PAC ID 4789845363, 289 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Dallas Medical Center Hospital, Dallas, TX, CCN 450051

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Endo Sedation LLC

  • Certified Registered Nurse Anesthetist
  • Keller, TX
  • NPI 1588931174

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• U. S. Anesthesia Partners of Texas, P.a.,

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1548208564

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Endo Sedation LLC

  • Certified Registered Nurse Anesthetist
  • Beaumont, TX
  • NPI 1548817471

  Nurse Anesthetist, Certified Registered

  NPD
• U S Anesthesia Partners of Texas, PA

  • Interventional Pain Medicine Physician
  • Addison, TX
  • NPI 1053800391

  Nurse Anesthetist, Certified Registered

  NPD
• Anesthesia Consultants of Dallas LLP

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1225298516
  NPD (past)
• Dallas Anesthesia & Pain Medicine Specialists LLP

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1346400645
  NPD (past)
• Excel Anesthesia, PA

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1548249147
  NPD (past)
• Southwest Fort Worth Anesthesiology Consultants, PA

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
  • NPI 1083605828

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

• Methodist Hospitals of Dallas

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1528027786
  Care Compare affiliation

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1619975448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853 STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844823",
            "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": "7205 LAKE MEAD BLVD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760164137",
            "telephone_number": "817-563-9211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6606 Lyndon B Johnson Fwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752406524",
            "country_code": "US",
            "telephone_number": "972-233-1999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "SUSAN",
        "middle_name": "M.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-14",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "542468",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP101864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126080404",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "89479C",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zandera Williams, LPC
• Crystal J. Williamson, MS, LCSW
• Willis Counseling Services, LLC
• Gary Glen Willis, OD
• Shirley Anne Willis, PH.D.
• Tamara Lynn Willmoth, PA-C
• Ambrosia Willoughby, PA-C
• Bethany Willoughby, SLP- INTERN
• Wilnick Surgical Supply
• A'Mia Michelle Wilson

• Certified Registered Nurse Anesthetist in Arlington, TX
• Providers in Arlington, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; 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.