NPIMap

Individual provider Active NPI

Terry Ray Brewer Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Jonesboro, AR
National Provider Identifier
1043410632
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
C02664 Issued in AR
Practice address
3024 Stadium Blvd
Jonesboro, AR 72401-7415
Phone
(501) 227-0700
Fax
(501) 227-0744
NPI assigned
Jul 20, 2007
Last updated
Jul 20, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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 C02664 AR Primary
Registered Nurse 163W00000X R54097 AR

Addresses

Primary practice location

3024 Stadium Blvd
Jonesboro, AR 72401-7415

Mailing address

PO Box 55990
Little Rock, AR 72215-5990
Phone (501) 227-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071026000046 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638266463 Reassigns benefits to 4 organizations
I20260408002911 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638266463 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Anesthesia Associates PLLCGroup PAC ID 6406023142, 85 clinicians
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

10201 Kanis Rd
Little Rock, AR 72205-6203
Phone (501) 227-5050

1235 E Cherokee St
Springfield, MO 65804-2203
Phone (417) 820-2600

624 Hospital Dr
Mountain Home, AR 72653-2955
Phone (870) 508-1000

761 Beard Dr
Mountain Home, AR 72653-2961
Phone (870) 508-6700

9500 Kanis Rd
Suite 401
Little Rock, AR 72205-6377
Phone (501) 227-9088

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R54097ARMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Asag, Inc. Nurse Anesthetist, Certified Registered Current Accepting new patients
Outpatient Surgery Center, Inc. CurrentSince May 6, 2024 Accepting new patients
Pain & the Gas, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 15, 2018 Accepting new patients
Baptist Memorial Hospital-Jonesboro Inc Past Accepting new patients
Arkansas Methodist Hospital Corporation Past Accepting new patients
Northeast Arkansas Health System LLC Past Accepting new patients

Locations

160 Highway 201 N
Mountain Home, AR 72653
Phone (870) 508-2100

400 10th St E
Waconia, MN 55387

Organizations & group practices 10

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184889600000",
    "number": "1043410632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55990",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722155990",
            "telephone_number": "501-227-0700",
            "fax_number": "501-227-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 STADIUM BLVD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017415",
            "telephone_number": "501-227-0700",
            "fax_number": "501-227-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "TERRY",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-20",
        "last_updated": "2007-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C02664",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R54097",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; 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.