Individual provider Active NPI

Mary K Pribble, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1649517988
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP145671 Issued in TX
Practice address
6606 LBJ Fwy Ste 200
Dallas, TX 75240-6524
Phone
(972) 715-5000
NPI assigned
Jan 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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 17143 TN
Certified Registered Nurse Anesthetist 367500000X AP145671 TX Primary

Addresses

Primary practice location

6606 LBJ Fwy Ste 200
Dallas, TX 75240-6524

Mailing address

PO Box 840853 Suite 435
Dallas, TX 75284-2013
Phone (972) 715-5000

Other names 1

  • Mary Grant Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200804000529 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587818802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan Anesthesia Consultants, LLPGroup PAC ID 3971516642, 137 clinicians

Practice addresses (Care Compare)

3300 Oak Lawn Ave
Suite 200
Dallas, TX 75219-4265
Phone (214) 252-3501

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP145671TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Anesthesia Consultants, LLP CurrentSince Apr 1, 2022 Accepting new patients
Endoscopy Center of St Thomas LLC Past Accepting new patients
Cardiovascular Anesthesiologists PC Nurse Anesthetist, Certified Registered PastSince Oct 29, 2023 Accepting new patients

Locations

3301 Matlock Rd
Arlington, TX 76015
Phone (682) 509-6200

9440 Poppy Dr
Dallas, TX 75218
Phone (214) 324-6100

3300 Oak Lawn Ave
Ste 200
Dallas, TX 75219
Phone (214) 252-3500

3625 N Hall St
Ste 800
Dallas, TX 75219
Phone (214) 252-3500

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

12505 Lebanon Rd
Frisco, TX 75035
Phone (972) 731-4800

Organizations & group practices 3

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": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1649517988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853 SUITE 435",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752842013",
            "telephone_number": "972-715-5000",
            "fax_number": "615-292-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6606 LBJ FWY STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406524",
            "telephone_number": "972-715-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIBBLE",
        "first_name": "MARY",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "17143",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP145671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "GRANT",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.