Individual provider Active NPI

Brenda L Porter

  • Certified Registered Nurse Anesthetist
  • Wichita Falls, TX
National Provider Identifier
1780690651
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
041104 Issued in TX
Practice address
1105 Brook Ave
Wichita Falls, TX 76301-5008
Phone
(940) 723-1441
Fax
(940) 766-3659
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 041104 TX Primary

Addresses

Primary practice location

1105 Brook Ave
Wichita Falls, TX 76301-5008

Mailing address

PO Box 5166
Wichita Falls, TX 76307-5166
Phone (940) 723-1441

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040802000438 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163493511 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Practice addresses (Care Compare)

1712 11TH St
Wichita Falls, TX 76301-5020
Phone (940) 723-2499

5420 Kell Blvd
Wichita Falls, TX 76310-1610
Phone (940) 692-5888

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041104TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Texoma Outpatient Surgery Center, Inc. CurrentSince Jun 1, 2012 Accepting new patients
Texoma Outpatient Surgery Center, Inc. Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2012 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2021 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2017 Accepting new patients
Red River Anesthesiology Group L.L.P. Past Accepting new patients
North Texas Anesthesia Group L.L.P. Past Accepting new patients
North Texas Anesthesia Group L.L.P Past Accepting new patients
Kell Anesthesia Billing Company Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

1305 Wonder World Dr
Ste 105
San Marcos, TX 78666
Phone (512) 353-8161

1712 11th St
Wichita Falls, TX 76301
Phone (940) 723-2499

5420 Kell Blvd
Wichita Falls, TX 76310
Phone (940) 692-5888

Organizations & group practices 8

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1780690651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5166",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763075166",
            "telephone_number": "940-723-1441",
            "fax_number": "940-766-3659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 BROOK AVE",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763015008",
            "telephone_number": "940-723-1441",
            "fax_number": "940-766-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "BRENDA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "041104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.