Clearfork Anesthesia Associates, PLLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

CLEARFORK ANESTHESIA ASSOCIATES, PLLC

Practice address

6311 Southwest Blvd
Benbrook, TX 76132-1063

Phone

(817) 731-2795

NPI assigned

Mar 3, 2020

Last updated

Mar 3, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bradley Keneson, D.O.NPI 1528369592

Title

Owner/Physician

Phone

(765) 284-0493

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bradley James Keneson, DO

  • Pain Medicine (Anesthesiology) Physician
  • Granbury, TX
  • NPI 1528369592
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1689208316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1889",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473081889",
            "telephone_number": "765-284-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6311 SOUTHWEST BLVD",
            "city": "BENBROOK",
            "state": "TX",
            "postal_code": "761321063",
            "telephone_number": "817-731-2795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARFORK ANESTHESIA ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-03",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "KENESON",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "765-284-0493",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Citlali Cisneros
• City of Benbrook
• John Randolph Clark, LPC
• Patricia Clark, FNP
• Clear Anesthetic Solutions, PLLC
• Michaela Colbert
• Laura Michelle Cole, RN
• Jasmine Conner-Allen
• Emily Conner
• Mireyah Constancio

• Anesthesiology Physician in Benbrook, TX
• Providers in Benbrook, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.