Tristan Blake Bennett, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

C002981 Issued in AR

Practice address

1910 Malvern Ave
Hot Springs, AR 71901-7752

Phone

(501) 321-1000

Fax

(870) 722-2421

NPI assigned

Apr 25, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Blake Bennett Other name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christus Health Ark-la-TexGroup PAC ID 2264325588, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Christus Health Ark-la-Tex

  • General Practice Physician
  • Texarkana, TX
  • NPI 1184623266
  Medicare reassignment Care Compare group NPD
• Northstar Anesthesia III PA

  • Anesthesiology Physician
  • Corpus Christi, TX
  • NPI 1356968952

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Northstar Anesthesia, PA

  • Anesthesiology Physician
  • Arlington, TX
  • NPI 1912978610

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Christus Health Ark-la-Tex

  • Rehabilitation Hospital Unit
  • Texarkana, TX
  • NPI 1467453902
  NPD
• Christus Health Ark-la-Tex

  • Hematology & Oncology Physician
  • Texarkana, TX
  • NPI 1790162238
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Health Ark-la-Tex

  • General Practice Physician
  • Texarkana, TX
  • NPI 1184623266

  Hospital

  Care Compare affiliation
• Christus Health Ark-la-Tex

  • General Acute Care Hospital
  • Texarkana, TX
  • NPI 1295736734
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation

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

{
    "created_epoch": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386806400000",
    "number": "1689018202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22390",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719032390",
            "telephone_number": "800-235-1415",
            "fax_number": "913-234-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 MALVERN AVE",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719017752",
            "telephone_number": "501-321-1000",
            "fax_number": "870-722-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "TRISTAN",
        "middle_name": "BLAKE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-25",
        "last_updated": "2013-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C002981",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "CTP000234",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197567001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01230606",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLAKE",
            "last_name": "BENNETT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sara Benett, LPN
• Michael Joseph Benke, MD
• Destiny Bennett
• Makenzie Bennett, DPT
• Richard C Bennett II, D.P.M.
• Mikael Elizabeth Estis Benoit, DNP-NA, CRNA, APRN
• Joe Benton III
• Michelle Berg
• Stephanie Berg, LPN
• Michael Berich

• Certified Registered Nurse Anesthetist in Hot Springs, AR
• Providers in Hot Springs, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; 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.