Individual provider Active NPI

Brogan Rister

  • Certified Registered Nurse Anesthetist
  • Midland, MI
National Provider Identifier
1174226716
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704345099 Issued in MI
Practice address
4000 Wellness Dr
Midland, MI 48670-2000
Phone
(989) 839-3000
NPI assigned
Mar 23, 2023
Last updated
Jun 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704345099 MI
Certified Registered Nurse Anesthetist 367500000X 4704345099 MI Primary

Addresses

Primary practice location

4000 Wellness Dr
Midland, MI 48670-2000

Mailing address

2708 Scott St
Midland, MI 48642-4712

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240709003271 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688119126 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asa Staffing IncGroup PAC ID 3971898644, 146 clinicians
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

1900 Columbus Ave
Bay City, MI 48708-6831
Phone (989) 894-3000

4000 Wellness Dr
Midland, MI 48670-2000
Phone (989) 839-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704345099MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland CurrentSince Jun 7, 2024 Accepting new patients
Asa Staffing Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2025 Accepting new patients
Mymichigan Medical Center Midland Nurse Anesthetist, Certified Registered CurrentSince Jun 7, 2024 Accepting new patients

Locations

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

L4355
Columbus, OH 43260

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1174226716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 SCOTT ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486424712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000",
            "telephone_number": "989-839-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISTER",
        "first_name": "BROGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704345099",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704345099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.