Individual provider Active NPI

Brent Mortensen, CRNP

  • Acute Care Nurse Practitioner
  • Cullman, AL
National Provider Identifier
1316308307
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-118166 Issued in AL
Practice address
1938 Al Highway 157 Ste 101
Cullman, AL 35058-1819
Phone
(256) 739-4030
NPI assigned
Mar 17, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-118166 AL Primary

Addresses

Primary practice location

1938 Al Highway 157 Ste 101
Cullman, AL 35058-1819

Mailing address

234 County Road 1408
Cullman, AL 35058-0539

Other practice location 1

1635 Highway 31 NW Ste C
Hartselle, AL 35640-4482
Phone (256) 735-5900

Other practice location 2

300 Hospital St
Moulton, AL 35650-1268
Phone (731) 394-1145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160504002347 AL Practitioner - Nurse Practitioner 5092014563 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Orthopaedic Center CurrentSince Jun 19, 2023 Accepting new patients
Ultra Health LLC CurrentSince Jul 11, 2024 Accepting new patients
HH Health System - the Orthopaedic Center, LLC CurrentSince Sep 9, 2023 Accepting new patients
Synergy Medical Partners, LLC PastSince Dec 1, 2020 Accepting new patients

Locations

22454 US Highway 72
Ste 200
Athens, AL 35613
Phone (256) 233-2332

927 Franklin St SE
Fl 3
Huntsville, AL 35801
Phone 25653927283326

927 Franklin St SE
Fl 2
Huntsville, AL 35801
Phone (256) 428-3000

5275 Millennium Dr NW
Huntsville, AL 35806
Phone (256) 489-6800

927 Franklin St SE
Fl 1
Huntsville, AL 35801

8415 Wann Dr NW
Madison, AL 35758
Phone (256) 704-1210

300 Hospital St
Moulton, AL 35650
Phone (256) 974-1146

1130 Hale St
Oxford, AL 36203
Phone (256) 831-0481

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-myrecord.cerner.com/r4/fca878a1-6c97-4ecb-b6e7-eb5d7cde15ab/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1316308307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 COUNTY ROAD 1408",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350580539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1938 AL HIGHWAY 157 STE 101",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350581819",
            "telephone_number": "256-739-4030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1635 Highway 31 NW Ste C",
            "address_purpose": "LOCATION",
            "city": "Hartselle",
            "state": "AL",
            "postal_code": "356404482",
            "country_code": "US",
            "telephone_number": "256-735-5900",
            "fax_number": "256-417-4719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Hospital St",
            "address_purpose": "LOCATION",
            "city": "Moulton",
            "state": "AL",
            "postal_code": "356501268",
            "country_code": "US",
            "telephone_number": "731-394-1145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "BRENT",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-17",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-118166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

Verify at the official NPI Registry.