Individual provider Active NPI

Michael Todd Brashear, CRNA

  • Certified Registered Nurse Anesthetist
  • Manchester, KY
National Provider Identifier
1205086097
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
46624 Issued in KY
Practice address
210 Marie Langdon Dr
Manchester, KY 40962-6388
Phone
(606) 598-5104
Fax
(606) 598-0983
NPI assigned
Sep 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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 46624 KY Primary

Addresses

Primary practice location

210 Marie Langdon Dr
Manchester, KY 40962-6388

Mailing address

425 Lewis Hargett Cir
Lexington, KY 40503-3590
Phone (859) 268-1030

Other practice location 1

100 Medical Center Dr
Hazard, KY 41701-9421
Phone (606) 439-6600

Other identifiers 2

IdentifierTypeStateIssuer
7100061300MedicaidKY
14175566OtherCAQH ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081223000501 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305908435 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

509 Memorial Dr
Suite 2
Manchester, KY 40962-6196

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46624KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sweet Dreams Anesthesia Inc Nurse Anesthetist, Certified Registered CurrentSince May 29, 2021 Accepting new patients
360 Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2024 Accepting new patients
Memorial Hospital, Inc. Nurse Anesthetist, Certified Registered Current Accepting new patients
Trustworthy Anesthesia Care Nurse Anesthetist, Certified Registered CurrentSince Mar 18, 2018 Accepting new patients
Kentucky Anesthesia Group, PSC Nurse Anesthetist, Certified Registered CurrentSince Aug 15, 2023 Accepting new patients
Memorial Hospital Inc. CurrentSince Oct 1, 2019 Accepting new patients
Memorial Hospital Inc CurrentSince Oct 1, 2019 Accepting new patients

Locations

108 Bravo Blvd
Glasgow, KY 42141
Phone (270) 651-2181

540 Jett Dr
Jackson, KY 41339
Phone (606) 666-4971

425 Lewis Hargett Cir
Lexington, KY 40503
Phone (606) 679-9322

2485 Highway 644
Louisa, KY 41230
Phone (606) 638-1154

210 Marie Langdon Dr
Manchester, KY 40962
Phone (865) 985-7047

9 Linville Dr
Paris, KY 40361
Phone (859) 987-3600

Organizations & group practices 8

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": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1205086097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 LEWIS HARGETT CIR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033590",
            "telephone_number": "859-268-1030",
            "fax_number": "859-269-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MARIE LANGDON DR",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409626388",
            "telephone_number": "606-598-5104",
            "fax_number": "606-598-0983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Hazard",
            "state": "KY",
            "postal_code": "417019421",
            "country_code": "US",
            "telephone_number": "606-439-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRASHEAR",
        "first_name": "MICHAEL",
        "middle_name": "TODD",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-29",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "46624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100061300",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "14175566",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.