Individual provider Active NPI

Audrey Ann Benedict

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1679313449
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1177370 Issued in TX
Practice address
6201 Harry Hines Blvd
Dallas, TX 75235-5202
Phone
(214) 633-5555
NPI assigned
May 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN270801 GA
Certified Registered Nurse Anesthetist 367500000X 1177370 TX Primary

Addresses

Primary practice location

6201 Harry Hines Blvd
Dallas, TX 75235-5202

Mailing address

1405 Bent Creek Dr
Southlake, TX 76092-9407
Phone (970) 980-7404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250113000457 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012445521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Emory University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

6201 Harry Hines Blvd
Dallas, TX 75235-5202
Phone (214) 648-6400

Hospital & facility affiliations

  • Ut of Texas Southwestern University Hospital - William P. Clements Jr. Hospital, Dallas, TX, CCN 450044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN270801GAMDRegistered Nurse
1177370TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Nurse Anesthetist, Certified Registered CurrentSince Dec 9, 2024 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Dec 9, 2024 Accepting new patients

Locations

5151 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-3000

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

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 and National Provider Directory roles.

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": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1679313449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 BENT CREEK DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929407",
            "telephone_number": "970-980-7404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752355202",
            "telephone_number": "214-633-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEDICT",
        "first_name": "AUDREY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-29",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN270801",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1177370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 13, 2025; 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.