Individual provider Active NPI

David Restrepo, CRNA

  • Certified Registered Nurse Anesthetist
  • College Station, TX
National Provider Identifier
1639830755
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1063850 Issued in TX
Practice address
700 Scott and White Dr
College Station, TX 77845-6441
Phone
(979) 207-0100
NPI assigned
Jan 2, 2022
Last updated
Apr 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 139546 FL
Certified Registered Nurse Anesthetist 367500000X 1063850 TX Primary

Addresses

Primary practice location

700 Scott and White Dr
College Station, TX 77845-6441

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drestrepo940820@direct.sw.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220312000092 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345635207 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1280 Arrington Rd
Suite 200
College Station, TX 77845-8696
Phone (979) 207-6550

1700 University Dr E
College Station, TX 77840-2661
Phone (979) 691-3300

1700 University Dr E Entrance 16
Care Clinic College Station University Dr
College Station, TX 77840-2661
Phone (979) 207-3636

700 Scott and White Dr
College Station, TX 77845-6441
Phone (979) 207-0100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
139546FLMDCertified Registered Nurse Anesthetist
1063850TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Current Accepting new patients
Scott & White Clinic CurrentSince Mar 2, 2022 Accepting new patients
Scott & White Clinic CurrentSince Mar 2, 2022 Accepting new patients

Locations

700 Medical Pkwy
Brenham, TX 77833
Phone (979) 337-5000

1280 Arrington Rd
Ste 200
College Station, TX 77845
Phone (979) 207-6550

700 Scott and White Dr
College Station, TX 77845
Phone (979) 207-0100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

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": "1641081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1639830755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SCOTT AND WHITE DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456441",
            "telephone_number": "979-207-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESTREPO",
        "first_name": "DAVID",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-02",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "139546",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1063850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drestrepo940820@direct.sw.org",
            "affiliation": "N",
            "address_1": "700 Scott and White Dr",
            "city": "College Station",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778456441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.