Individual provider Active NPI

David Walker Phillips, CRNA

  • Certified Registered Nurse Anesthetist
  • College Station, TX
National Provider Identifier
1669543955
Registry record updated May 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP119883 Issued in TX
Practice address
700 Scott and White Dr
College Station, TX 77845-6441
Phone
(979) 207-0100
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2016

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 RN193091 NC
Certified Registered Nurse Anesthetist 367500000X AP119883 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
Phone (254) 724-8800

Other identifiers 2

IdentifierTypeStateIssuer
8052854MedicaidNC
P00679669OtherNCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070612000814 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688772791 Reassigns benefits to 1 organization
I20160415000088 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688772791 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Duke University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woodlands Anesthesia Associates LLCGroup PAC ID 4183967540, 6 clinicians
Anesthesia Associates of Bryan, LLCGroup PAC ID 1254659378, 11 clinicians

Practice addresses (Care Compare)

111 Vision Park Blvd
Suite 160
Shenandoah, TX 77384-3005
Phone (936) 321-8910

2206 E Villa Maria Rd
Bryan, TX 77802-2547
Phone (979) 774-4211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN193091NCMDCertified Registered Nurse Anesthetist
AP119883TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Anesthesiology Group, PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 23, 2021 Accepting new patients
Anesthesia Associates of Bryan LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 28, 2017 Accepting new patients
Nash Hospitals Inc Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2009 Accepting new patients
Nash Hospitals Inc CurrentSince Aug 1, 2009 Accepting new patients
Anesthesia Medical Group of the Permian Basin, LLP CurrentSince May 1, 2020 Accepting new patients
Austin Anesthesiology Group PLLC CurrentSince Apr 23, 2021 Accepting new patients
Grasshopper Anesthesia Services PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2022 Accepting new patients
Woodlands Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2023 Accepting new patients
United Regional Health Care System Inc Current Accepting new patients
Wichita Falls Anesthesia PLLC CurrentSince May 13, 2024 Accepting new patients
East Carolina Anesthesia Associates, PLLC Nurse Anesthetist, Certified Registered PastSince Jan 1, 2006 Accepting new patients
Colorado Personnel Resources Inc Past Accepting new patients

Locations

2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

2206 E Villa Maria Rd
Bryan, TX 77802
Phone (979) 774-4211

110 Shult Dr
Columbus, TX 78934
Phone (979) 493-7560

200 W Ollie St
Llano, TX 78643
Phone (325) 216-9199

703 E Marshall Ave
Ste 2000
Longview, TX 75601
Phone (903) 236-5300

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

811 S Washington Ave
Marshall, TX 75670
Phone (903) 315-1488

400 Rosalind Redfern Grover Pkwy
Midland, TX 79701
Phone (432) 221-4850

5609 Deauville
Midland, TX 79706
Phone (432) 697-3629

3610 N University Dr
Nacogdoches, TX 75965
Phone (936) 254-4703

3302 NE Stallings Dr
Nacogdoches, TX 75965
Phone (936) 564-2411

1204 N Mound St
Nacogdoches, TX 75961
Phone (936) 564-4611

200 S Interstate 35
Pearsall, TX 78061
Phone (888) 250-2326

111 Vision Park Blvd
Ste 160
Shenandoah, TX 77384
Phone (936) 321-8910

1600 11th St
Wichita Falls, TX 76301
Phone (940) 263-3000

Interoperability endpoints

  • Direct secure messaging: dphillips76415@unitedregional.medalliesdirect.net
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462924800000",
    "number": "1669543955",
    "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",
            "telephone_number": "254-724-8800"
        },
        {
            "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": "PHILLIPS",
        "first_name": "DAVID",
        "middle_name": "WALKER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2016-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "RN193091",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP119883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8052854",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00679669",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "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 May 11, 2016; 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.