Individual provider Active NPI

Bradley Richad Leamy, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Smith, AR
National Provider Identifier
1194775791
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2401 Issued in SC
Practice address
12409 Havishum CT
Fort Smith, AR 72916-6026
Phone
(417) 207-7003
NPI assigned
May 12, 2006
Last updated
Jan 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 102664 MO
Certified Registered Nurse Anesthetist 367500000X C02854 AR
Certified Registered Nurse Anesthetist 367500000X 2401 SC Primary

Addresses

Primary practice location

12409 Havishum CT
Fort Smith, AR 72916-6026

Mailing address

12409 Havishum CT
Fort Smith, AR 72916-6026
Phone (417) 207-7003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110523000211 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335102318 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renew Medical Group of Arkansas LTDGroup PAC ID 3173056298, 129 clinicians

Practice addresses (Care Compare)

7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone (479) 314-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2401SCMDOptometrist
C02854ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Medical Group of Arkansas LTD Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2024 Accepting new patients
Western Arkansas Anesthesiology Associates P.a. CurrentSince Apr 14, 2022 Accepting new patients
Western Arkansas Obstetric Anesthesia LLC CurrentSince Jan 15, 2022 Accepting new patients
Freeman Neosho Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Associates of Kansas City PA Past Accepting new patients
Laboratory Corportation of America Holdings Past Accepting new patients
Racine Anesthesia Services, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
St John's Regional Medical Center Nurse Anesthetist, Certified Registered Past Accepting new patients
Ozark Anesthesia Associates, Inc. PastSince Jun 17, 2002 Accepting new patients
St Johns Regional Medical Center Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

6801 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-6000

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

Organizations & group practices 10

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 1

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1194775791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12409 HAVISHUM CT",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729166026",
            "telephone_number": "417-207-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12409 HAVISHUM CT",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729166026",
            "telephone_number": "417-207-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAMY",
        "first_name": "BRADLEY",
        "middle_name": "RICHAD",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "102664",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C02854",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.