Active NPI
Brenn Mitchell Johnson, CRNA
- Certified Registered Nurse Anesthetist
- Martin, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN173849
- Practice address
- 161 Mount Pelia Rd
Martin, TN 38237-3811 - Phone
- (731) 588-0001
- Fax
- (731) 587-2775
- NPI assigned
- Dec 16, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN173849 | TN | Primary |
Addresses
Primary practice location
161 Mount Pelia Rd
Martin, TN 38237-3811
Mailing address
410 N Cedar Bluff Rd
Ste 300
Knoxville, TN 37923-3632
Phone (865) 342-8900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, NC
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
50 Capital Ave
Jackson, TN 38305-5507
Phone (731) 661-9825
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.05 of 100
- Promoting interoperability
- 98
- Improvement activities
- 40
- Cost
- 73.85
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7062 | NC | MD | Occupational Therapist |
| RN173849 | TN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vidant Medical Group LLC | Current | Accepting new patients | |
| Medical Center Anesthesia Inc. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| West Tennessee Bone and Joint Clinic PC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Jackson Anesthesiology Group, PLLC | Past | Accepting new patients |
Locations
401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941
250 Smith Church Rd
Roanoke Rapids, NC 27870
Phone (252) 308-9699
620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923
24 Physicians Dr
Jackson, TN 38305
Phone (731) 661-9825
50 Capital Ave
Jackson, TN 38305
Phone (731) 661-9825
Organizations & group practices 5
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.
-
- Specialist
- Jackson, TN
- NPI 1831312461
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Jackson, TN
- NPI 1447591730
Nurse Anesthetist, Certified Registered
-
- Multi-Specialty Clinic/Center
- Greenville, NC
- NPI 1477648731
-
- Certified Registered Nurse Anesthetist
- Martin, TN
- NPI 1326107327
-
- Anesthesiology Physician
- Jackson, TN
- NPI 1770187734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671753600000",
"number": "1396166427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 N CEDAR BLUFF RD",
"address_2": "STE 300",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379233632",
"telephone_number": "865-342-8900",
"fax_number": "865-691-0843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 MOUNT PELIA RD",
"city": "MARTIN",
"state": "TN",
"postal_code": "382373811",
"telephone_number": "731-588-0001",
"fax_number": "731-587-2775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "BRENN",
"middle_name": "MITCHELL",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-12-16",
"last_updated": "2022-12-23",
"certification_date": "2022-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "RN173849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Martin, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; 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.