NPIMap

Individual provider Active NPI

Braden Williams

  • Certified Registered Nurse Anesthetist
  • Rapid City, SD
National Provider Identifier
1295278356
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
00969999 Issued in SD
Practice address
6123 Covenant Dr
Rapid City, SD 57702-9524
Phone
(605) 430-2492
NPI assigned
Nov 22, 2016
Last updated
Jun 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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 00969999 SD Primary

Addresses

Primary practice location

6123 Covenant Dr
Rapid City, SD 57702-9524

Mailing address

6123 Covenant Dr
Rapid City, SD 57702-9524
Phone (605) 430-2492

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210506003041 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234406547 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Black Hills Surgical Hospital LLCGroup PAC ID 5496742835, 173 clinicians

Practice addresses (Care Compare)

216 Anamaria Dr
Rapid City, SD 57701-7366

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00969999SDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Peloton Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2023 Accepting new patients
Black Hills Surgical Hospital, LLC CurrentSince Nov 30, 2023 Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Apr 14, 2021 Accepting new patients
Black Hills Surgical Hospital, LLC CurrentSince Nov 30, 2023 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Apr 14, 2021 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

1868 Lombardy Dr
Rapid City, SD 57703
Phone (605) 721-4900

216 Anamaria Dr
Rapid City, SD 57701
Phone (605) 388-9440

2820 Mount Rushmore Rd
Rapid City, SD 57701
Phone (605) 721-8121

Organizations & group practices 7

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1295278356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6123 COVENANT DR",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577029524",
            "telephone_number": "605-430-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6123 COVENANT DR",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577029524",
            "telephone_number": "605-430-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRADEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-22",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SD",
            "license": "00969999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.