Individual provider Active NPI

Amanda Rena Brown, CRNA

  • Certified Registered Nurse Anesthetist
  • Panama City, FL
National Provider Identifier
1235261595
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9216040 Issued in FL
Practice address
653 W. 23Rd
#284
Panama City, FL 32405
Phone
(850) 896-8799
Fax
(850) 896-8799
NPI assigned
Mar 12, 2007
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN149514 GA
Certified Registered Nurse Anesthetist 367500000X 4386 SC
Certified Registered Nurse Anesthetist 367500000X 9216040 FL Primary

Addresses

Primary practice location

653 W. 23Rd
#284
Panama City, FL 32405

Mailing address

653 W. 23Rd
#284
Panama City, FL 32404
Phone (850) 896-8799

Other identifiers 2

IdentifierTypeStateIssuer
000503500MedicaidFL
BH925ZOtherFLMEDICARE

Other names 1

  • Mrs. Amanda Rena Witherspoon Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090211000175 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567567845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

202 Doctors Dr
Panama City, FL 32405-4454
Phone (850) 522-1930

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4386SCMDPhysician Assistant
9216040FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
The Surgical Center for Excellence, LLLP CurrentSince Jun 8, 2018 Accepting new patients
Antebellum Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 22, 2017 Accepting new patients
East Memphis Anesthesia Services PLC PastSince May 16, 2021 Accepting new patients
Sweet Dreams of Albany LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Rural Health Pain Management LLC PastSince Dec 8, 2024 Accepting new patients

Locations

653 W 23rd St
Panama City, FL 32405
Phone (850) 819-5614

202 Doctors Dr
Panama City, FL 32405
Phone (850) 482-7200

Organizations & group practices 5

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1235261595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 W. 23RD",
            "address_2": "#284",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "32404",
            "telephone_number": "850-896-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 W. 23RD",
            "address_2": "#284",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "32405",
            "telephone_number": "850-896-8799",
            "fax_number": "850-896-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "AMANDA",
        "middle_name": "RENA",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN149514",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "4386",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9216040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000503500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "BH925Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WITHERSPOON",
            "middle_name": "RENA",
            "prefix": "MRS.",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Panama City, FL

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.