Individual provider Active NPI

Gabriela Kim Nuckols, CRNA

  • Certified Registered Nurse Anesthetist
  • Decatur, TX
National Provider Identifier
1861883514
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP127882 Issued in TX
Practice address
609 Medical Center Dr
Decatur, TX 76234-3836
Phone
(770) 643-5619
NPI assigned
Feb 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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 AP127882 TX Primary

Addresses

Primary practice location

609 Medical Center Dr
Decatur, TX 76234-3836

Mailing address

4754 Emerald Trace Way
Fort Worth, TX 76244-6951
Phone (682) 215-8219

Other names 1

  • Gabriela Kim McBride Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151222000335 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133420854 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia III PAGroup PAC ID 0042630501, 393 clinicians

Practice addresses (Care Compare)

1401 E 8TH St
Weslaco, TX 78596-6640
Phone (956) 968-8567

3315 S Alameda St
Corpus Christi, TX 78411-1820
Phone (214) 687-0001

5501 S Expressway
Suite 77
Harlingen, TX 78550-3213
Phone (956) 365-1000

609 Medical Ctr Dr
Decatur, TX 76234-3836
Phone (940) 627-5921

7218 Crawford Rd
Argyle, TX 76226-2579
Phone (940) 293-2885

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP127882TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2016 Accepting new patients
Premier Anesthesia of Huntsville a Division of Premier Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2018 Accepting new patients
U S Anesthesia Partners of Texas, PA Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2016 Accepting new patients

Locations

4401 Garth Rd
Baytown, TX 77521
Phone (281) 420-8500

609 Medical Center Dr
Decatur, TX 76234
Phone (940) 626-1360

5501 S Expressway 77
Harlingen, TX 78550
Phone (936) 569-9481

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

1401 E 8th St
Weslaco, TX 78596
Phone (956) 581-0303

Interoperability endpoints

  • Direct secure messaging: gabriela.nuckols.1@11284.direct.athenahealth.com

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.

Hospital & facility affiliations 1

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": "1424044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1861883514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4754 EMERALD TRACE WAY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446951",
            "telephone_number": "682-215-8219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 MEDICAL CENTER DR",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343836",
            "telephone_number": "770-643-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUCKOLS",
        "first_name": "GABRIELA",
        "middle_name": "KIM",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-16",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP127882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GABRIELA",
            "last_name": "MCBRIDE",
            "middle_name": "KIM",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Decatur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; 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.