Individual provider Active NPI

Brenda Wingham, DNP, CRNA

  • Certified Registered Nurse Anesthetist
  • Louisville, KY
National Provider Identifier
1316597982
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1137225 Issued in KY
Practice address
4000 Kresge Way
Louisville, KY 40207-4605
Phone
(502) 897-8100
NPI assigned
Sep 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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 1137225 KY Primary

Addresses

Primary practice location

4000 Kresge Way
Louisville, KY 40207-4605

Mailing address

3000 Overlook Trce
New Albany, IN 47150-5269

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 1111111111 Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201118000583 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638580970
I20260602000214 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638580970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
One Anesthesia PLLCGroup PAC ID 7113816174, 13 clinicians

Practice addresses (Care Compare)

1220 Missouri Ave
RM 2547
Jeffersonville, IN 47130-3725
Phone (812) 282-6631

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1137225KYMDCertified Registered Nurse Anesthetist

Organizations & group practices 1

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": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1316597982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 OVERLOOK TRCE",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471505269"
        },
        {
            "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": "502-897-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINGHAM",
        "first_name": "BRENDA",
        "name_prefix": "Dr.",
        "credential": "DNP, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1137225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "1111111111",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "0000000000",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "1111111111",
            "address_1": "4000 Kresge Way",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Sep 16, 2019; 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.