Theresa B Halliburton, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

C01018 CRNA Issued in AR

Practice address

11115 So Waldron Rd
107
Fort Smith, AR 72903-2584

Phone

(479) 452-1581

Fax

(479) 452-2148

NPI assigned

Dec 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Theresa B McDermott Former name

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renew Medical Group of Arkansas LTDGroup PAC ID 3173056298, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Renew Medical Group of Arkansas LTD

  • Anesthesiology Physician
  • Fort Smith, AR
  • NPI 1215755947

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Western Arkansas Anesthesiology Associates P.a.

  • Anesthesiology Physician
  • Fort Smith, AR
  • NPI 1548202294
  Medicare reassignment NPD
• Western Arkansas Obstetric Anesthesia LLC

  • Anesthesiology Physician
  • Fort Smith, AR
  • NPI 1952671703
  Medicare reassignment NPD
• Bentonville Anesthesia PLLC

  • Anesthesiology Physician
  • Bentonville, AR
  • NPI 1447281670

  Nurse Anesthetist, Certified Registered

  NPD (past)
• QHG of Springdale Inc

  • Neonatal-Perinatal Medicine Physician
  • Springdale, AR
  • NPI 1730292434
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  Care Compare affiliation

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1922176437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11880",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729171880",
            "telephone_number": "479-452-1581",
            "fax_number": "479-452-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11115 SO WALDRON RD",
            "address_2": "107",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032584",
            "telephone_number": "479-452-1581",
            "fax_number": "479-452-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLIBURTON",
        "first_name": "THERESA",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C01018  CRNA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136416701",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "MCDERMOTT",
            "middle_name": "B",
            "credential": "CRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jordan Hall
• Mary Jane Hall, M.S., CCC/SLP
• Peyton Hall
• Angel Ann Hallauer, MS CCC SLP
• Kathryn Denyse Hallen, CRNA
• Hamidullah Hamid
• Khadijah Hamid, DO
• Hamilton Center for Child Advocacy
• Erin Marie Hamilton, APRN-FNP
• Jayce Lee Hamilton, MSN APRN FNP-BC

• Certified Registered Nurse Anesthetist in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; 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.