Individual provider Active NPI

Kevin Pannell, DNP, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
National Provider Identifier
1912516170
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1026882 Issued in TX
Practice address
1400 8TH Ave
Fort Worth, TX 76104-4110
Phone
(214) 687-0001
NPI assigned
Jul 23, 2020
Last updated
Apr 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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 1026882 TX Primary
Registered Nurse 163W00000X 891645 TX

Addresses

Primary practice location

1400 8TH Ave
Fort Worth, TX 76104-4110

Mailing address

6225 N State Highway 161 Ste 200
Irving, TX 75038-2241
Phone (214) 687-0001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210330000561 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284041773 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Allied Anesthesia, PLLCGroup PAC ID 1052698172, 23 clinicians

Practice addresses (Care Compare)

Richardson, TX 75080
Phone (214) 660-5266

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
891645TXMDRegistered Nurse
1026882TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Arlington Anesthesia Group, PLLC CurrentSince Nov 1, 2022 Accepting new patients
Northstar Anesthesia III PA Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2021 Accepting new patients
Northstar Anesthesia II PA Nurse Anesthetist, Certified Registered CurrentSince Jan 26, 2021 Accepting new patients
Texas Allied Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 28, 2024 Accepting new patients
South Arlington Surgical Providers, LLC CurrentSince Nov 1, 2022 Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Feb 8, 2021 Accepting new patients

Locations

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

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

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

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

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

6225 State Highway 161
Ste 200
Irving, TX 75038
Phone (214) 687-0496

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

2435 N Central Expy
Ste 1200
Richardson, TX 75080
Phone (214) 442-1900

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1912516170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 N STATE HIGHWAY 161 STE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382241",
            "telephone_number": "214-687-0001",
            "fax_number": "972-518-2100"
        },
        {
            "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": "214-687-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANNELL",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DNP, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-23",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1026882",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "891645",
            "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 8, 2021; 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.