Individual provider Active NPI

Bradley Louis Jones, CRNA

  • Certified Registered Nurse Anesthetist
  • Tyler, TX
National Provider Identifier
1104928068
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
664987 Issued in TX
Practice address
800 E Dawson St
Tyler, TX 75701-2036
Phone
(903) 531-5000
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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 AP04179 LA
Certified Registered Nurse Anesthetist 367500000X 664987 TX Primary

Addresses

Primary practice location

800 E Dawson St
Tyler, TX 75701-2036

Mailing address

PO Box 841656
Dallas, TX 75284-1656
Phone (903) 531-5000

Other identifiers 4

IdentifierTypeStateIssuer
P01198527OtherTXRAIL ROAD
75-0818167-015OtherTXTRICARE
8351UEOtherTXBCBS BLUE
289953603MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060410000203 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496764060 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Health Northern LouisianaGroup PAC ID 8628980554, 25 clinicians
Novus Louisiana Medical Professional CorporationGroup PAC ID 5395194880, 23 clinicians
Christus Health Central LouisianaGroup PAC ID 4688570955, 46 clinicians

Practice addresses (Care Compare)

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800
Phone (318) 681-6678

1500 Line Ave
Suite 206
Shreveport, LA 71101-4649
Phone (318) 213-3800

1635 Marvel St
Coushatta, LA 71019-9022
Phone (318) 932-2199

Hospital & facility affiliations

  • Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041
  • Specialists Hospital Shreveport Hospital, Shreveport, LA, CCN 190278
  • Christus Coushatta Health Care Center Hospital, Coushatta, LA, CCN 191312

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP04179LAMDCertified Registered Nurse Anesthetist
664987TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Shreveport Sedation Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2025 Accepting new patients
Christus Health Central Louisiana CurrentSince Jun 15, 2024 Accepting new patients
Novus Louisiana Medical Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2023 Accepting new patients
Christus Health Central Louisiana CurrentSince Jun 15, 2024 Accepting new patients
Christus Health Northern Louisiana Nurse Anesthetist, Certified Registered Current Accepting new patients
Medical Center Anesthesiologists CurrentSince Jun 2, 2015 Accepting new patients
Med-Trans Corporation Past Accepting new patients
Willis Knighton Medical Center Inc. Crna Group Nurse Anesthetist, Certified Registered Past Accepting new patients
Christus Health Central Louisiana Past Accepting new patients

Locations

1635 Marvel St
Coushatta, LA 71019
Phone (318) 932-2000

708 N Ashley Ridge Loop
Ste 400
Shreveport, LA 71106
Phone (318) 210-3315

1 Saint Mary Pl
Shreveport, LA 71101
Phone (318) 681-4500

1500 Line Ave
Ste 206
Shreveport, LA 71101
Phone (318) 213-3800

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

1455 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 300-3643

1500 Line Ave
Shreveport, LA 71101
Phone (318) 213-3754

3217 Mabel St
Shreveport, LA 71103

Organizations & group practices 9

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1104928068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841656",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752841656",
            "telephone_number": "903-531-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E DAWSON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012036",
            "telephone_number": "903-531-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "BRADLEY",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP04179",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "664987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD",
            "identifier": "P01198527",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-015",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BLUE",
            "identifier": "8351UE",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "289953603",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; 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.