Individual provider Active NPI

Brendan Sansom, CRNA

  • Certified Registered Nurse Anesthetist
  • Birmingham, AL
National Provider Identifier
1245629997
Registry record updated Jan 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-127296 Issued in AL
Practice address
619 19TH St S
Room-Jt845
Birmingham, AL 35249-1900
Phone
(205) 979-5882
Fax
(205) 979-1248
NPI assigned
Jan 19, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2015

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 1-127296 AL Primary

Addresses

Primary practice location

619 19TH St S
Room-Jt845
Birmingham, AL 35249-1900

Mailing address

PO Box 11407
Attn: Dept 1717
Birmingham, AL 35246-0100
Phone (205) 979-5882

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150409002127 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709104466 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Alabama School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Alabama Health Services Foundation, PCGroup PAC ID 1951213107, 2,784 clinicians

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35246-0001
Phone (205) 934-3460

Hospital & facility affiliations

  • University of Alabama Hospital Hospital, Birmingham, AL, CCN 010033

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama at Birmingham Current Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Jun 1, 2017 Accepting new patients
University of Alabama at Birmingham Nurse Anesthetist, Certified Registered CurrentSince Jan 12, 2015 Accepting new patients
University of Alabama at Birmingham CurrentSince Jan 12, 2015 Accepting new patients

Locations

1022 1st St N
Ste 500
Alabaster, AL 35007
Phone (205) 663-5775

619 19th St S
Rm JT845
Birmingham, AL 35249
Phone (205) 934-7072

619 19th St S
#845
Birmingham, AL 35249
Phone (205) 934-7072

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

Interoperability endpoints

  • Direct secure messaging: bfsansom@direct.uabmedicine.org

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.

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": "1421625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421625600000",
    "number": "1245629997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407",
            "address_2": "ATTN: DEPT 1717",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352460100",
            "telephone_number": "205-979-5882",
            "fax_number": "205-979-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 19TH ST S",
            "address_2": "ROOM-JT845",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352491900",
            "telephone_number": "205-979-5882",
            "fax_number": "205-979-1248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANSOM",
        "first_name": "BRENDAN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-19",
        "last_updated": "2015-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-127296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2015; 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.