Anastacia Marie Brandenburg, AGCNS-BC

Primary specialty

Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X

License

71012266A Issued in IN

Practice address

14 Trafalgar SQ
Trafalgar, IN 46181-9515

Phone

(812) 636-1343

Fax

(812) 526-4900

NPI assigned

Dec 29, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Anastacia Marie Sorg Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Windrose Health Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hope, IN
  • NPI 1346520426
  NPD (past)

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1346837002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 TRAFALGAR SQ",
            "city": "TRAFALGAR",
            "state": "IN",
            "postal_code": "461819515",
            "telephone_number": "812-636-1343",
            "fax_number": "812-526-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 TRAFALGAR SQ",
            "city": "TRAFALGAR",
            "state": "IN",
            "postal_code": "461819515",
            "telephone_number": "812-636-1343",
            "fax_number": "812-526-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDENBURG",
        "first_name": "ANASTACIA",
        "middle_name": "MARIE",
        "credential": "AGCNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-29",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IN",
            "license": "28093774A",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "IN",
            "license": "71012266A",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "IN",
            "license": "71012266A",
            "primary": false
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "IN",
            "license": "71012266A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANASTACIA",
            "last_name": "SORG",
            "middle_name": "MARIE",
            "credential": "AG-CNS-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adaptiv8 LLC
• Brian Keith Albertson, M.D.
• Lesley Blakley
• Michael W Chitwood, M.D.
• Crossroads Family Dentistry
• Dungarvin Indiana, LLC
• Dungarvin Indiana, LLC
• Jenis Emily Feldhake, DDS

• Gerontology Clinical Nurse Specialist in Trafalgar, IN
• Providers in Trafalgar, IN by specialty
• Gerontology Clinical Nurse Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.