Individual provider Active NPI

Brandon Gabe Graves, DNP CRNA

  • Certified Registered Nurse Anesthetist
  • Carrollton, GA
National Provider Identifier
1104478916
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN288492 Issued in GA
Practice address
705 Dixie St
Carrollton, GA 30117-3818
Phone
(770) 812-9666
NPI assigned
Jul 11, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2020

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 AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X 239737 AZ
Certified Registered Nurse Anesthetist 367500000X RN288492 GA Primary

Addresses

Primary practice location

705 Dixie St
Carrollton, GA 30117-3818

Mailing address

645 E Missouri Ave
Ste 300
Phoenix, AZ 85012-1351
Phone (602) 262-8917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200512002751 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981934254 Reassigns benefits to 7 organizations
I20260623000720 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981934254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Arizona College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians
Northeastern Anesthesia PLLCGroup PAC ID 4284813940, 83 clinicians

Practice addresses (Care Compare)

1120 S Utica Ave
HC Med Ctr
Tulsa, OK 74104-4012
Phone (918) 579-1000

2200 E Show Low Lake Rd
Show Low, AZ 85901-7831
Phone (928) 537-4375

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
63.31 of 100Reported as group
Quality
74.88
Improvement activities
0
Cost
73.76

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Alphonsus Professional Medical Services LLC Single Specialty CurrentSince Jan 6, 2025 Accepting new patients
Valley Regional Anesthesia Associates Inc Single Specialty CurrentSince Aug 17, 2024 Accepting new patients
Ascend Anesthesia LLC Single Specialty CurrentSince Jun 1, 2025 Accepting new patients
Valley Anesthesiology Consultants, Inc. Single Specialty CurrentSince Jun 1, 2020 Accepting new patients
Northeastern Anesthesia PLLC Single Specialty CurrentSince Feb 13, 2025 Accepting new patients
St Alphonsus Professional Medical Services LLC Single Specialty CurrentSince Jan 6, 2025 Accepting new patients
Summit Anesthesia Services PLLC Single Specialty CurrentSince Jan 16, 2024 Accepting new patients
Greater Anesthesia Solutions Single Specialty CurrentSince Oct 17, 2022 Accepting new patients
Pinnacle Global Health LLC Past Accepting new patients

Locations

560 N Switzer Canyon Dr
Flagstaff, AZ 86001
Phone (928) 774-3044

5330 S Highway 95
Fort Mohave, AZ 86426
Phone (928) 788-2273

5656 S Power Rd
Gilbert, AZ 85295
Phone (480) 840-3733

18701 N 67th Ave
Glendale, AZ 85308
Phone (623) 561-1000

5880 S Hospital Dr
Globe, AZ 85501
Phone (928) 402-1217

1775 McCulloch Blvd N
Lk Havasu Cty, AZ 86403
Phone (925) 453-0696

101 Civic Center Ln
Lk Havasu Cty, AZ 86403
Phone (928) 453-0150

1500 S Dobson Rd
Ste 101
Mesa, AZ 85202
Phone (480) 306-6098

1800 E Van Buren St
Phoenix, AZ 85006
Phone (602) 251-8100

1902 W Union Hills Dr
Unit 41340
Phoenix, AZ 85080

645 E Missouri Ave
Ste 300
Phoenix, AZ 85012
Phone (602) 262-8917

3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000

1902 W Union Hills Dr
Unit 41550
Phoenix, AZ 85080

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004
Phone (602) 744-4760

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

5700 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

6200 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 229-2657

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

Organizations & group practices 11

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 3

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": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1104478916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 E MISSOURI AVE",
            "address_2": "STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121351",
            "telephone_number": "602-262-8917",
            "fax_number": "602-262-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 DIXIE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173818",
            "telephone_number": "770-812-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "BRANDON",
        "middle_name": "GABE",
        "credential": "DNP CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-11",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "239737",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN288492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.