Organization Active NPI

New Brooke Anesthesiologists PC

  • Anesthesiology Physician
  • New Albany, IN
National Provider Identifier
1104968957
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
NEW BROOKE ANESTHESIOLOGISTS PC
Practice address
3018 Brookhaven Rd
New Albany, IN 47150-9439
Phone
(812) 945-2047
NPI assigned
Feb 12, 2007
Last updated
Nov 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Nieves C Antonio, MDNPI 1942302120
Title
Secretary
Phone
(812) 945-2047

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

3018 Brookhaven Rd
New Albany, IN 47150-9439

Mailing address

3018 Brookhaven Rd
New Albany, IN 47150-9439
Phone (812) 945-2047

Other identifiers 1

IdentifierTypeStateIssuer
100405570AMedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1104968957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3018 BROOKHAVEN RD",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471509439",
            "telephone_number": "812-945-2047",
            "fax_number": "812-945-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3018 BROOKHAVEN RD",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471509439",
            "telephone_number": "812-945-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW BROOKE ANESTHESIOLOGISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "ANTONIO",
        "authorized_official_first_name": "NIEVES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "812-945-2047",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100405570A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.