Individual provider Active NPI

Brent E Mitchell, CRNA

  • Certified Registered Nurse Anesthetist
  • Greenwood Village, CO
National Provider Identifier
1063401149
Registry record updated Jul 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R41329 Issued in NM
Practice address
8200 E Belleview Ave
Greenwood Village, CO 80111-2803
Phone
(303) 290-0600
Fax
(303) 290-6359
NPI assigned
Oct 20, 2005
Last updated
Jul 6, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2009

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 695165 TX
Certified Registered Nurse Anesthetist 367500000X R41329 NM Primary

Addresses

Primary practice location

8200 E Belleview Ave
Greenwood Village, CO 80111-2803

Mailing address

1819 Denver West Drive
Suite 200
Golden, CO 80401-3118
Phone (303) 422-9438

Other identifiers 1

IdentifierTypeStateIssuer
17372224MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070613000216 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385742428 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5612COMDChiropractor
695165TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Radius Anesthesia of New Mexico LLC CurrentSince Oct 23, 2025 Accepting new patients
Anesthesia Associates of the Rockies LLC Past Accepting new patients

Locations

111 Town Square Pl
Ste 420
Jersey City, NJ 07310
Phone (201) 258-4700

4901 Lang Ave NE
Ste 100
Albuquerque, NM 87109
Phone (505) 883-2574

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246838400000",
    "number": "1063401149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 DENVER WEST DRIVE",
            "address_2": "SUITE 200",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804013118",
            "telephone_number": "303-422-9438",
            "fax_number": "303-422-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 E BELLEVIEW AVE",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112803",
            "telephone_number": "303-290-0600",
            "fax_number": "303-290-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BRENT",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2009-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "695165",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "R41329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17372224",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood Village, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; 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.