Individual provider Active NPI

William C. Koggu, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1902142680
Registry record updated Dec 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
729920 Issued in TX
Practice address
5201 Harry Hines Blvd
Dept. of Anesthesiology
Dallas, TX 75235-7708
Phone
(214) 590-8329
NPI assigned
Dec 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2012

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 729920 TX Primary

Addresses

Primary practice location

5201 Harry Hines Blvd
Dept. of Anesthesiology
Dallas, TX 75235-7708

Mailing address

PO Box 660599
Dallas, TX 75266-0599

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130723000112 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698916377 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2021 Accepting new patients
Arlington Anesthesia Group, PLLC CurrentSince Aug 14, 2018 Accepting new patients
Dallas County Hospital District Current Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2021 Accepting new patients
Dallas County Hospital District Nurse Anesthetist, Certified Registered CurrentSince Feb 25, 2013 Accepting new patients
South Arlington Surgical Providers, LLC CurrentSince Jan 5, 2020 Accepting new patients
Dallas County Hospital District CurrentSince Feb 25, 2013 Accepting new patients

Locations

981 State Highway 121
Ste 2100
Allen, TX 75013
Phone (214) 383-8210

350 E Interstate 20
Ste 200
Arlington, TX 76018
Phone (214) 254-4299

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

3107 W Camp Wisdom Rd
Ste 189
Dallas, TX 75237
Phone (214) 331-2922

5494 Glen Lakes Dr
Dallas, TX 75231
Phone (214) 692-6220

1001 Surrey Ln
Flower Mound, TX 75022
Phone (817) 337-3671

180 Bear Creek Pkwy
Keller, TX 76248
Phone (817) 337-3671

2704 N Galloway Ave
Ste 102
Mesquite, TX 75150
Phone (972) 961-7171

3500 Preston Rd
Ste 200
Plano, TX 75093
Phone (972) 985-2300

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": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356566400000",
    "number": "1902142680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 HARRY HINES BLVD",
            "address_2": "DEPT. OF ANESTHESIOLOGY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357708",
            "telephone_number": "214-590-8329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGGU",
        "first_name": "WILLIAM",
        "middle_name": "C.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-27",
        "last_updated": "2012-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "729920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.