Individual provider Active NPI

Grayson Thomas Ford, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
National Provider Identifier
1669949293
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP140482 Issued in TX
Practice address
1400 8TH Ave
Fort Worth, TX 76104-4110
Phone
(504) 920-4729
NPI assigned
Nov 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 799542 TX
Certified Registered Nurse Anesthetist 367500000X AP140482 TX Primary

Addresses

Primary practice location

1400 8TH Ave
Fort Worth, TX 76104-4110

Mailing address

3421 Hamilton Ave
Fort Worth, TX 76107-1852
Phone (504) 920-4729

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190221002307 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567701360 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illume Anesthesia PLLCGroup PAC ID 5991160863, 14 clinicians

Practice addresses (Care Compare)

2600 W University Dr
Suite 100
McKinney, TX 75071-3209
Phone (972) 548-2015

8000 Eldorado Pkwy
McKinney, TX 75070-4136
Phone (972) 569-2700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
799542TXMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2021 Accepting new patients
Illume Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2023 Accepting new patients
DFW Oba PLLC CurrentSince Sep 1, 2022 Accepting new patients
Northstar Anesthesia II PA Nurse Anesthetist, Certified Registered CurrentSince Feb 5, 2019 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Feb 5, 2019 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2021 Accepting new patients

Locations

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

7101 S Padre Island Dr
Corpus Christi, TX 78412
Phone (361) 761-1400

9500 N Central Expy
Ste 200
Dallas, TX 75231
Phone (214) 739-9544

2321 Olympia Dr
Ste 100
Flower Mound, TX 75028
Phone (972) 350-0225

1001 Surrey Ln
Flower Mound, TX 75022
Phone (817) 337-3671

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

1401 8th Ave
Ft Worth, TX 76104
Phone (817) 334-2831

1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161

180 Bear Creek Pkwy
Keller, TX 76248
Phone (817) 337-3671

2600 W University Dr
Ste 100
McKinney, TX 75071
Phone (972) 548-2015

2704 N Galloway Ave
Ste 102
Mesquite, TX 75150
Phone (972) 961-7171

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

3500 Preston Rd
Ste 200
Plano, TX 75093
Phone (972) 985-2300

990 S Sherman St
Richardson, TX 75081
Phone (972) 788-0350

Organizations & group practices 7

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": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1669949293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 HAMILTON AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761071852",
            "telephone_number": "504-920-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044110",
            "telephone_number": "504-920-4729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "GRAYSON",
        "middle_name": "THOMAS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-01",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TX",
            "license": "799542",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP140482",
            "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 Mar 19, 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.