Individual provider Active NPI

Bradley Wade Lord, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Ocala, FL
National Provider Identifier
1245430602
Registry record updated Jul 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9189417 Issued in FL
Practice address
1500 SW 1St Ave
Ocala, FL 34471-6504
Phone
(352) 237-2400
Fax
(352) 237-9808
NPI assigned
Jul 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2007

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 9189417 FL Primary

Addresses

Primary practice location

1500 SW 1St Ave
Ocala, FL 34471-6504

Mailing address

7930 SW 84TH Way
Gainesville, FL 32608-6129
Phone (352) 376-1921

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071106000305 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183711211 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
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)

960 7TH Ave N
Saint Petersburg, FL 33705-1347
Phone (727) 821-8101

Hospital & facility affiliations

  • Manatee Memorial Hospital Hospital, Bradenton, FL, CCN 100035
  • Lakewood Ranch Medical Center Hospital, Bradenton, FL, CCN 100299

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9189417FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 30, 2019 Accepting new patients
Office Anesthesia Staffing Nurse Anesthetist, Certified Registered CurrentSince May 1, 2023 Accepting new patients
SMH Physician Services Inc CurrentSince Jun 26, 2023 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Apr 1, 2019 Accepting new patients
Fleming Island Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 18, 2023 Accepting new patients
Lakewood Ranch Anesthesia PL Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2010 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Apr 1, 2019 Accepting new patients
Anesthesiology Associates of North Florida PA Past Accepting new patients
Anesthesia Care Team, Inc. Past Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

6015 Pointe West Blvd
Ste 101
Bradenton, FL 34209
Phone (941) 782-0101

206 2nd St E
Bradenton, FL 34208
Phone (941) 745-7202

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

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

1109 US Highway 19
Holiday, FL 34691
Phone (727) 934-5705

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

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

2600 Laurel Rd E
North Venice, FL 34275
Phone (941) 261-9000

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

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

1325 Belcher Rd
Palm Harbor, FL 34683
Phone (816) 500-0021

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

960 7th Ave N
St Petersburg, FL 33705
Phone (727) 821-8101

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

Networks

  • Freedom Health HMO Network

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1245430602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7930 SW 84TH WAY",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326086129",
            "telephone_number": "352-376-1921",
            "fax_number": "352-372-6956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SW 1ST AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344716504",
            "telephone_number": "352-237-2400",
            "fax_number": "352-237-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORD",
        "first_name": "BRADLEY",
        "middle_name": "WADE",
        "name_prefix": "Mr.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9189417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.