Active NPI
Baker Mays Roberson
- Certified Registered Nurse Anesthetist
- Fort Worth, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 1107916
- Practice address
- 1400 8TH Ave
Fort Worth, TX 76104-4110 - Phone
- (817) 926-2544
- NPI assigned
- Jan 18, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 1107916 | TX | Primary |
| Registered Nurse | 163W00000X | 914997 | TX |
Addresses
Primary practice location
1400 8TH Ave
Fort Worth, TX 76104-4110
Mailing address
3105 Spotted Fawn Dr
Fort Worth, TX 76108-1444
Phone (817) 694-3541
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1400 8TH Ave
Fort Worth, TX 76104-4110
Phone (817) 926-2544
Hospital & facility affiliations
- Medical City Fort Worth
- Baylor Scott and White All Saints Medical Center
- Baylor Scott & White Heart & Vascular Hospital - Dallas
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 914997 | TX | MD | Registered Nurse |
| 1107916 | TX | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trinity Medical Associates, PLLC. | Current | Accepting new patients | |
| Northstar Anesthesia, PA | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Minerva Labs LLC | Current | Accepting new patients | |
| Northstar Anesthesia III PA | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400
621 N Hall St
Dallas, TX 75226
Phone (214) 820-0600
7115 Greenville Ave
Dallas, TX 75231
Phone (214) 369-7115
1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559
909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060
750 13th Ave
Ft Worth, TX 76104
Phone (817) 334-5050
1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161
6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000
1203 S White Chapel Blvd
Ste 150
Southlake, TX 76092
Phone (817) 333-9898
Organizations & group practices 4
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.
-
- Anesthesiology Physician
- Corpus Christi, TX
- NPI 1356968952
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Arlington, TX
- NPI 1912978610
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Fort Worth, TX
- NPI 1932611654
-
- Clinical Medical Laboratory
- Southlake, TX
- NPI 1053112938
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Worth, TX
- NPI 1669472387
-
- General Acute Care Hospital
- Fort Worth, TX
- NPI 1659323772
-
- General Acute Care Hospital
- Dallas, TX
- NPI 1609855139
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682294400000",
"number": "1801501432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3105 SPOTTED FAWN DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761081444",
"telephone_number": "817-694-3541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 8TH AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761044110",
"telephone_number": "817-926-2544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERSON",
"first_name": "BAKER",
"middle_name": "MAYS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-01-18",
"last_updated": "2023-04-24",
"certification_date": "2023-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "1107916",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TX",
"license": "914997",
"primary": false
}
],
"identifiers": [],
"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 Apr 24, 2023; 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.