BRENT WILLIS (NPI# 1104363258) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104363258 |
| Entity Type | Individual |
| Full Name | BRENT WILLIS |
| Credential | CRNA |
| Practice Address |
203 La Grange Dr. Texarkana TX 75501 |
| Practice Telephone | 9366455428 |
| Mailing Telephone | 9366455428 |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2017-01-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | AP133014 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
203 LA GRANGE DR. |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598227951 | Shayla Lasonde Williams | Licensed Vocational Nurse | 409 Tracey Ave, Wake Village, TX 75501 | 2019-04-04 |
| 1861900904 | Tiffany Anne Baugus | Nurse Practitioner | 2600 St. Michael Drive, Texarkana, TX 75501 | 2018-01-10 |
| 1154627644 | Patricia Maree Baker | Counselor | 1001 Texas Blvd., Suite 106, Texarkana, TX 75501 | 2011-02-01 |
| 1730323452 | William Leonard | Occupational Therapy Assistant | 2108 5th Street, Bridgeport, TX 75501 | 2009-04-24 |
| 1700071552 | Roger House Md, Psychiatric Services | Case Management | 2401 Summerhill Rd., Suite A, Texarkana, TX 75501 | 2007-09-13 |
| 1134248271 | Brent Bultemeier Pa | Chiropractor | 3207 New Boston Road, Texarkana, TX 75501 | 2007-03-28 |
| 1346395977 | Sharon E. Moore | Registered Nurse | Youree Drive, Shreveport, LA 75501 | 2007-01-24 |
| 1962553024 | Leary Independent School District | Local Education Agency (LEA) | 9500 W. New Boston Rd, Texarkana, TX 75501 | 2007-01-16 |
| 1780787390 | Christina Michelle Griffin | Physical Therapist | 1315 Walnut, Temple Memorial Rehabiliation Ctr, Texarkana, TX 75501 | 2006-09-07 |
| 1871530204 | Albertsons LLC | Durable Medical Equipment & Medical Supplies | 4415 W 7th St, Wake Village, TX 75501 | 2006-06-02 |
| Find all providers in zip 75501 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477164440 | Royal Anesthesia Inc. | Nurse Anesthetist, Certified Registered | 1802 Moores Ln Ste 200, Texarkana, TX 75503-4609 | 2020-08-13 |
| 1467009621 | Texarkana Sedation LLC | Nurse Anesthetist, Certified Registered | 1902 Moores Ln Ste B, Texarkana, TX 75503-4668 | 2019-08-22 |
| 1720101934 | Office Anesthesia Service LLC | Nurse Anesthetist, Certified Registered | 1730 Galleria Oaks Dr, Texarkana, TX 75503-4649 | 2007-04-10 |
| 1861483547 | Cesar Jonathan Baylon | Nurse Anesthetist, Certified Registered | 3211 Sugar Hilrd L, Texarkana, AR 71854 | 2005-11-02 |
| 1740288638 | David F Sellers | Nurse Anesthetist, Certified Registered | 4080 Summerhill Sq, Texarkana, TX 75503-2730 | 2005-07-13 |
| 1588662837 | Per I Eiane | Nurse Anesthetist, Certified Registered | 4500 Summerhill Rd, Texarkana, TX 75503-2740 | 2005-07-11 |
| 1689182438 | Lab Anesthesia Pllc | Nurse Anesthetist, Certified Registered | 1902 Moores Ln, Texarkana, TX 75503-4610 | 2018-01-15 |
| 1790101384 | Anesthesiology Associates of Texarkana Pa | Nurse Anesthetist, Certified Registered | 4100 Summerhill Rd, Texarkana, TX 75503-2732 | 2014-03-06 |
| 1700211737 | Twice Nice Anesthesia Associates, Pllc | Nurse Anesthetist, Certified Registered | 1000 Pine St, Texarkana, TX 75501-5100 | 2013-09-10 |
| 1255678298 | Justin G. Fitts | Nurse Anesthetist, Certified Registered | 4100 Summerhill Rd, Texarkana, TX 75503-2732 | 2013-01-10 |
| Find all providers in TEXARKANA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.