Bradley W Ketron, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

23732 Issued in TN

Practice address

1 Medical Park Blvd
Bristol, TN 37620-7430

Phone

(423) 844-2686

Fax

(423) 844-2688

NPI assigned

Sep 25, 2017

Last updated

Feb 22, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paragon Anesthesia PCGroup PAC ID 8921044744, 214 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Paragon Anesthesia PC

  • Anesthesiology Physician
  • Kingsport, TN
  • NPI 1538174974

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• East Tennessee Ambulatory Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Johnson City, TN
  • NPI 1659360071
  NPD
• Singing River Health System

  dba Inpatient Physician Services

  • Internal Medicine Physician
  • Pascagoula, MS
  • NPI 1134283419
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Wellmont Health System

  dba Bristol Regional Medical Center

  • General Acute Care Hospital
  • Bristol, TN
  • NPI 1124058615
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1255840088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W STONE DR STE 6A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603256",
            "telephone_number": "423-408-7220",
            "fax_number": "423-408-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207430",
            "telephone_number": "423-844-2686",
            "fax_number": "423-844-2688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETRON",
        "first_name": "BRADLEY",
        "middle_name": "W",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-25",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "182189",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "23732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Mai Kennedy, PA
• Jessica Lynn Kennedy, DPT
• Ryan Christopher Kennedy, M.D.
• Laurenrose Faith Kessler, OTD, OTR/L
• Alicia Nicole Kestner, FNP-C
• John C. Kilbreath, P.T.
• Brian Keith Killen, PA-C
• King University (King University Athletics)
• Brandy Shanks King, CRNA
• Jessica Erin King, PSY.D.

• Certified Registered Nurse Anesthetist in Bristol, TN
• Providers in Bristol, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; 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.