Individual provider Active NPI

Daniel C Bradberry

  • Certified Registered Nurse Anesthetist
  • Nashville, TN
National Provider Identifier
1043671647
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
21246 Issued in TN
Practice address
110 29TH Ave N
Suite 202
Nashville, TN 37203-1401
Phone
(615) 327-7870
Fax
(615) 921-5506
NPI assigned
Mar 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 178536 TN
Certified Registered Nurse Anesthetist 367500000X 21246 TN Primary

Addresses

Primary practice location

110 29TH Ave N
Suite 202
Nashville, TN 37203-1401

Mailing address

110 29TH Ave N
Suite 202
Nashville, TN 37203-1401
Phone (615) 327-7870

Other identifiers 1

IdentifierTypeStateIssuer
Q022209MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160718001420 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628361318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Medical Group, P.C.Group PAC ID 6901702307, 439 clinicians

Practice addresses (Care Compare)

2000 Church St
Nashville, TN 37236-0001
Phone (615) 284-5555

2300 Patterson St
Nashville, TN 37203-1538
Phone (615) 342-1000

Hospital & facility affiliations

  • Tristar Centennial Medical Center Hospital, Nashville, TN, CCN 440161

Merit-based Incentive Payment System (MIPS)

Final score
65.57 of 100Reported as group
Quality
59.49
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
178536TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Medical Group, PC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2016 Accepting new patients

Locations

2000 Church St
Nashville, TN 37236
Phone (615) 284-4672

110 29th Ave N
Ste 202
Nashville, TN 37203
Phone (615) 327-7870

2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1457568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1043671647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 29TH AVE N",
            "address_2": "SUITE 202",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031401",
            "telephone_number": "615-327-7870",
            "fax_number": "615-921-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 29TH AVE N",
            "address_2": "SUITE 202",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031401",
            "telephone_number": "615-327-7870",
            "fax_number": "615-921-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADBERRY",
        "first_name": "DANIEL",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-10",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "178536",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "21246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q022209",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.