Individual provider Active NPI

Charles Alan Miner, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
National Provider Identifier
1770590937
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
739985 Issued in TX
Practice address
801 7TH Ave
Fort Worth, TX 76104-2733
Phone
(682) 885-3199
Fax
(682) 885-7499
NPI assigned
Aug 1, 2006
Last updated
Aug 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0001190931 VA
Certified Registered Nurse Anesthetist 367500000X 739985 TX Primary

Addresses

Primary practice location

801 7TH Ave
Fort Worth, TX 76104-2733

Mailing address

PO Box 99213
Fort Worth, TX 76199-0213
Phone (682) 885-1855

Other identifiers 2

IdentifierTypeStateIssuer
201533101MedicaidTX
8133UUOtherTXBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090507000226 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749338424 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia III PAGroup PAC ID 0042630501, 393 clinicians
Northstar Anesthesia PAGroup PAC ID 7315907128, 231 clinicians

Practice addresses (Care Compare)

11801 S Fwy
Burleson, TX 76028-7021
Phone (817) 856-0665

1400 8TH Ave
Fort Worth, TX 76104-4110
Phone (817) 926-2544

201 Walls Dr
Cleburne, TX 76033-4007
Phone (817) 641-2551

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001190931VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc CurrentSince Nov 5, 2010 Accepting new patients
Regional Employee Assistance Program Inc CurrentSince Nov 5, 2010 Accepting new patients
Northstar Anesthesia III PA Nurse Anesthetist, Certified Registered CurrentSince Jan 31, 2025 Accepting new patients
Regional Employee Assistance Program Inc Current Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Feb 11, 2011 Accepting new patients

Locations

2000 E Lamar Blvd
Ste 400
Arlington, TX 76006
Phone (817) 861-3994

201 Walls Dr
Cleburne, TX 76033
Phone (817) 556-5587

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

621 N Hall St
Dallas, TX 75226
Phone (214) 820-0600

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

3055 GRN MDW Dr
San Angelo, TX 76904

3055 GRN MDW Dr
San Angelo, TX 76904

411 N Belknap St
Stephenville, TX 76401
Phone (254) 965-1500

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1770590937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99213",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990213",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 7TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042733",
            "telephone_number": "682-885-3199",
            "fax_number": "682-885-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINER",
        "first_name": "CHARLES",
        "middle_name": "ALAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0001190931",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "739985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201533101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8133UU",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; 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.