Individual provider Active NPI

Denise L Brickson, CRNA

  • Certified Registered Nurse Anesthetist
  • Worthington, MN
National Provider Identifier
1164480299
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
D-083572 Issued in IA
Practice address
1680 Diagonal Rd
Worthington, MN 56187-1008
Phone
(507) 372-3800
Fax
(507) 372-3806
NPI assigned
May 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 D-083572 IA Primary

Addresses

Primary practice location

1680 Diagonal Rd
Worthington, MN 56187-1008

Mailing address

1680 Diagonal Rd
Worthington, MN 56187-1008
Phone (507) 372-3800

Other identifiers 3

IdentifierTypeStateIssuer
28510OtherIABLUE CROSS BLUE SHIELD
0226423MedicaidIA
P00057073OtherIARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120518000143 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9436049681 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians

Practice addresses (Care Compare)

100 N Dean Rd
Suite 102
Orlando, FL 32825-3710
Phone (407) 506-0006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D-083572IAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ams Anesthetist Services LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2018 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince May 21, 2024 Accepting new patients
Fleming Island Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince May 24, 2024 Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Jul 15, 2019 Accepting new patients

Locations

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

4571 Colonial Blvd
Ste 200
Fort Myers, FL 33966
Phone (239) 333-2050

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

110 N Lecanto Hwy
Lecanto, FL 34461
Phone (352) 527-1825

9035 Sunset Dr
Ste 200
Miami, FL 33173
Phone (786) 615-6210

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

1670 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 541-3048

100 N Dean Rd
Ste 102
Orlando, FL 32825
Phone (407) 506-0006

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

120 E Par St
Ste 2000
Orlando, FL 32804
Phone (407) 843-5665

1800 Jenks Ave
Panama City, FL 32405
Phone (850) 769-3191

767 Airport Rd
Panama City, FL 32405
Phone (850) 747-0400

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1164480299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 DIAGONAL RD",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561871008",
            "telephone_number": "507-372-3800",
            "fax_number": "507-372-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 DIAGONAL RD",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561871008",
            "telephone_number": "507-372-3800",
            "fax_number": "507-372-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICKSON",
        "first_name": "DENISE",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D-083572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "28510",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0226423",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00057073",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.