Individual provider Active NPI

Bracan John Williams, CRNA

  • Certified Registered Nurse Anesthetist
  • Everett, WA
National Provider Identifier
1063787836
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP60499120 Issued in WA
Practice address
12833 51St Ave SE
Everett, WA 98208-9618
Phone
(206) 919-5082
NPI assigned
Mar 13, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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 201142666RN OR
Certified Registered Nurse Anesthetist 367500000X AP60499120 WA Primary

Addresses

Primary practice location

12833 51St Ave SE
Everett, WA 98208-9618

Mailing address

12833 51St Ave SE
Everett, WA 98208-9618
Phone (206) 919-5082

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150121000134 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466776570 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Oregon Health Sciences University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

888 Swift Blvd
Richland, WA 99352-3514
Phone (509) 946-4611

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201142666RNORMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 30, 2022 Accepting new patients
Premier Anesthesia of Richland a Division of Premier Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2024 Accepting new patients

Locations

900 S Auburn St
Kennewick, WA 99336
Phone (509) 586-5111

3810 Plaza Way
Kennewick, WA 99338
Phone (509) 221-7000

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1351 Fowler St
Ste 330
Richland, WA 99352

Organizations & group practices 2

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": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1063787836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12833 51ST AVE SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982089618",
            "telephone_number": "206-919-5082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12833 51ST AVE SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982089618",
            "telephone_number": "206-919-5082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRACAN",
        "middle_name": "JOHN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-13",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201142666RN",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60499120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; 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.