Active NPI
Brian C Bane, M.D.
- Anesthesiology Physician
- Usaf Academy, CO
National Provider Identifier
1053587683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 35.127062
- Practice address
- 4102 Pinion Dr
Usaf Academy, CO 80840-2502 - Phone
- (719) 333-5115
- NPI assigned
- May 4, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 35.127062 | OH | Primary |
| Anesthesiology Physician | 207L00000X | MT188693 | PA |
Addresses
Primary practice location
4102 Pinion Dr
Usaf Academy, CO 80840-2502
Mailing address
4102 Pinion Dr
Usaf Academy, CO 80840-2502
Phone (719) 333-5115
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT188693 | PA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720483200000",
"number": "1053587683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4102 PINION DR",
"city": "USAF ACADEMY",
"state": "CO",
"postal_code": "808402502",
"telephone_number": "719-333-5115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4102 PINION DR",
"city": "USAF ACADEMY",
"state": "CO",
"postal_code": "808402502",
"telephone_number": "719-333-5115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANE",
"first_name": "BRIAN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-04",
"last_updated": "2024-07-09",
"certification_date": "2024-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OH",
"license": "35.127062",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "PA",
"license": "MT188693",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Usaf Academy, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.