Individual provider Active NPI

Bradley Wayne Lewis, CRNA

  • Certified Registered Nurse Anesthetist
  • Louisville, KY
National Provider Identifier
1316186273
Registry record updated Feb 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
47107 Issued in KY
Practice address
4000 Kresge Way
Louisville, KY 40207-4605
Phone
(502) 473-2100
Fax
(502) 459-6461
NPI assigned
Feb 16, 2009
Last updated
Feb 16, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2009

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 47107 KY Primary

Addresses

Primary practice location

4000 Kresge Way
Louisville, KY 40207-4605

Mailing address

PO Box 70354
Louisville, KY 40270-0354
Phone (502) 473-2132

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121119000093 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002973484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (984) 974-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill Current Accepting new patients
University of North Carolina at Chapel Hill CurrentSince Sep 17, 2012 Accepting new patients
One Anesthesia PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

Organizations & group practices 3

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 1

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": "1234742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234742400000",
    "number": "1316186273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70354",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402700354",
            "telephone_number": "502-473-2132",
            "fax_number": "502-459-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 KRESGE WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074605",
            "telephone_number": "502-473-2100",
            "fax_number": "502-459-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "BRADLEY",
        "middle_name": "WAYNE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-16",
        "last_updated": "2009-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "47107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2009; 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.