Individual provider Active NPI

Kelly Ann Braden, CRNA

  • Certified Registered Nurse Anesthetist
  • Cleveland, TN
National Provider Identifier
1336120609
Registry record updated Mar 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN83320 Issued in TN
Practice address
2080 Chambliss Ave NW
Cleveland Anesthesiologists Inc
Cleveland, TN 37311-3894
Phone
(423) 472-6514
Fax
(423) 476-2062
NPI assigned
Nov 14, 2005
Last updated
Mar 9, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 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 RN83320 TN Primary

Addresses

Primary practice location

2080 Chambliss Ave NW
Cleveland Anesthesiologists Inc
Cleveland, TN 37311-3894

Mailing address

PO Box 3090
Cleveland, TN 37320-3090
Phone (423) 472-6513

Other identifiers 1

IdentifierTypeStateIssuer
3626782MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090416000407 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042367682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology Consultants Exchange, PCGroup PAC ID 2365434297, 152 clinicians

Practice addresses (Care Compare)

1751 Gunbarrel Rd
Chattanooga, TN 37421-7177
Phone (423) 602-8400

975 E 3Rd St
Chattanooga, TN 37403-2173
Phone (423) 602-8400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN83320TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Consultants Exchange, PC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2009 Accepting new patients
Anesthesiologists Associated PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesiologists Associated PC Past Accepting new patients
Cleveland Anesthesiologists Inc PastSince Oct 8, 2012 Accepting new patients

Locations

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

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, 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": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236556800000",
    "number": "1336120609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3090",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373203090",
            "telephone_number": "423-472-6513",
            "fax_number": "423-476-2062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CHAMBLISS AVE NW",
            "address_2": "CLEVELAND ANESTHESIOLOGISTS INC",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113894",
            "telephone_number": "423-472-6514",
            "fax_number": "423-476-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADEN",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2009-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN83320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3626782",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.