Individual provider Active NPI

Daron V Brabham, CRNA

  • Certified Registered Nurse Anesthetist
  • Baton Rouge, LA
National Provider Identifier
1144568635
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP07137 Issued in LA
Practice address
8212 Summa Ave
Baton Rouge, LA 70809-3421
Phone
(225) 769-4403
NPI assigned
Jan 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP07137 LA Primary

Addresses

Primary practice location

8212 Summa Ave
Baton Rouge, LA 70809-3421

Mailing address

8212 Summa Ave
Baton Rouge, LA 70809-3421
Phone (225) 769-4403

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190522000786 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496990376 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integral Anesthesia LLCGroup PAC ID 9638461973, 159 clinicians

Practice addresses (Care Compare)

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (919) 744-3131

3029 W Main St
Jenks, OK 74037-3465
Phone (918) 701-2300

Hospital & facility affiliations

  • Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP07137LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Integral Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2025 Accepting new patients
Northstar Anesthesia of Oklahoma, PLLC CurrentSince Jan 12, 2023 Accepting new patients

Locations

3029 W Main St
Jenks, OK 74037
Phone (918) 346-5002

5602 SW Lee Blvd
Lawton, OK 73505
Phone (580) 531-4700

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

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 2

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": "1358467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1144568635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8212 SUMMA AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093421",
            "telephone_number": "225-769-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8212 SUMMA AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093421",
            "telephone_number": "225-769-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRABHAM",
        "first_name": "DARON",
        "middle_name": "V",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-18",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP07137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; 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.