Individual provider Active NPI

Jon D Speed, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1720403173
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP125372 Issued in TX
Practice address
12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Phone
(972) 715-5000
Fax
(972) 715-9976
NPI assigned
Feb 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0024179520 VA
Certified Registered Nurse Anesthetist 367500000X 1-106956 AL
Certified Registered Nurse Anesthetist 367500000X RN187388 GA
Certified Registered Nurse Anesthetist 367500000X AP125372 TX Primary

Addresses

Primary practice location

12222 Merit Dr Ste 600
Dallas, TX 75251-3294

Mailing address

PO Box 840853
Dallas, TX 75284-0853
Phone (972) 233-1999

Other practice location 1

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-3138

Other practice location 2

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000

Other identifiers 1

IdentifierTypeStateIssuer
337983601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140818002564 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042437865 Reassigns benefits to 4 organizations
I20180921002686 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042437865 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelinc Anesthesia PLLCGroup PAC ID 0941347447, 169 clinicians
Endo Sedation LLCGroup PAC ID 4789845363, 289 clinicians

Practice addresses (Care Compare)

75 Shell St
Suite 100
Saraland, AL 36571-2202
Phone (251) 481-6231

855 Proton Rd
San Antonio, TX 78258-4203
Phone (210) 614-1234

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN187388GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medicine Associates CurrentSince Mar 27, 2023 Accepting new patients
Veronox Anesthesia, LLC CurrentSince Apr 15, 2019 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Anesthetist, Certified Registered CurrentSince May 15, 2022 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Oct 3, 2022 Accepting new patients
Dothan Anesthesiology Associates PC CurrentSince Jul 9, 2018 Accepting new patients
U S Anesthesia Partners of Texas, PA Nurse Anesthetist, Certified Registered CurrentSince May 15, 2022 Accepting new patients
James S. Trimble, M.D. P.a. Past Accepting new patients

Locations

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

201 E Watts St
Enterprise, AL 36330
Phone (334) 383-5474

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 361-1844

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

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

7703 Floyd Curl Dr
Rm 4
San Antonio, TX 78229
Phone (210) 567-3053

5223 Hamilton Wolfe Rd
San Antonio, TX 78229
Phone 2106141234713

11212 State Highway 151
San Antonio, TX 78251
Phone (210) 281-5066

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

855 Proton Rd
San Antonio, TX 78258
Phone (210) 582-8000

1301 Wonder World Dr
San Marcos, TX 78666
Phone (512) 353-8979

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

Interoperability endpoints

  • Direct secure messaging: jspeed523173@uhssa.direct-ci.com

Organizations & group practices 10

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": "1392940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1720403173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "972-233-1999",
            "fax_number": "997-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12222 MERIT DR STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752513294",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Gallows Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423307",
            "country_code": "US",
            "telephone_number": "703-776-3138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4502 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782294402",
            "country_code": "US",
            "telephone_number": "210-358-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPEED",
        "first_name": "JON",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-21",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024179520",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-106956",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN187388",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP125372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "337983601",
            "state": "TX"
        }
    ],
    "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 May 1, 2024; 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.