Condred W Roberts, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

220314 Issued in TX

Practice address

3201 W Highway 22
Corsicana, TX 75110

Phone

(903) 654-6812

NPI assigned

Jun 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237766400000",
    "number": "1770527947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1836",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "75110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 W HIGHWAY 22",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "75110",
            "telephone_number": "903-654-6812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CONDRED",
        "middle_name": "W",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2009-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "220314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "88170U",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023418-03",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002341804",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Blake Richardson, D.D.S.
• Mario P. Ridad
• Merideth Riedel, COTA
• Emilye Robbins
• Robert W Adelman Et Al PTR Kelman and Associates
• Dania Lizbeth Rodriguez, CPHT
• Ronald L Rodriguez, DO
• Rypin Rogers
• Emmah Rosana, RPH
• Kelly L. Ross, DO

• Certified Registered Nurse Anesthetist in Corsicana, TX
• Providers in Corsicana, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.