Individual provider Active NPI

Kenneth James Roeger, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1982178018
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP140339 Issued in TX
Practice address
1935 Medical District Dr
Dallas, TX 75235-7701
Phone
(214) 456-6393
Fax
(214) 456-5587
NPI assigned
Jan 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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 836156 TX
Certified Registered Nurse Anesthetist 367500000X AP140339 TX Primary

Addresses

Primary practice location

1935 Medical District Dr
Dallas, TX 75235-7701

Mailing address

1935 Medical District Dr
Dallas, TX 75235-7701
Phone (214) 456-6393

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kroeger441419@direct.sw.org Direct
Direct Messaging Address kroeger441419@direct.sw.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190220001142 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880932698 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
836156TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hillcrest Physician Services CurrentSince Apr 12, 2023 Accepting new patients
Dallas Physician Medical Services for Children Inc CurrentSince Feb 12, 2025 Accepting new patients
Orthomed Staffing LLC CurrentSince May 18, 2023 Accepting new patients
Valiant Anesthesia Associates, PLLC CurrentSince Jul 1, 2023 Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Feb 27, 2023 Accepting new patients
Dallas Physician Medical Services for Children Inc CurrentSince Feb 12, 2025 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients
Complex Care Medical Services Corporation Past Accepting new patients

Locations

1105 Central Expy N
Ste 2100
Allen, TX 75013
Phone (972) 747-6401

801 W Interstate 20
Arlington, TX 76017
Phone (817) 472-3400

1935 Medical District Dr
Ste EL171
Dallas, TX 75235

2350 N Stemmons Fwy
Dallas, TX 75207
Phone (469) 488-7100

2727 E Lemmon Ave
Dallas, TX 75204
Phone (214) 443-3000

14850 Quorum Dr
Ste 400
Dallas, TX 75254
Phone (214) 801-1879

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

7 Medical Pkwy
Farmers Brnch, TX 75234
Phone (972) 247-1000

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

1800 Park Place Ave
Ft Worth, TX 76110
Phone (682) 703-5600

1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161

7211 Preston Rd
Ste 2100
Plano, TX 75024
Phone (469) 303-0104

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

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

2201 K Ave
Ste B100
Plano, TX 75074
Phone (214) 931-6133

100 Hillcrest Medical Blvd
Waco, TX 76712
Phone (254) 202-2000

50 Hillcrest Medical Blvd
Waco, TX 76712
Phone (254) 202-7300

Interoperability endpoints

  • Direct secure messaging: kroeger715832@direct.childrens.com
  • Direct secure messaging: kroeger441419@direct.sw.org

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": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1982178018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-6393",
            "fax_number": "214-456-5587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-6393",
            "fax_number": "214-456-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEGER",
        "first_name": "KENNETH",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-11",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "836156",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP140339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kroeger441419@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 Hillcrest Medical Blvd",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "76712",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kroeger441419@direct.sw.org",
            "affiliation": "N",
            "address_1": "100 Hillcrest Medical Blvd",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "76712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Feb 19, 2025; 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.