Active NPI
Brandon Allen, CRNA
- Certified Registered Nurse Anesthetist
- Fort Moore, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- AP61189448
- Practice address
- 6600 Van Aalst Blvd
Fort Moore, GA 31905-2102 - Phone
- (762) 408-2273
- NPI assigned
- Jul 15, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN316457 | GA | |
| Certified Registered Nurse Anesthetist | 367500000X | AP61189448 | WA | Primary |
Addresses
Primary practice location
6600 Van Aalst Blvd
Fort Moore, GA 31905-2102
Mailing address
6600 Van Aalst Blvd
Fort Moore, GA 31905-2102
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231013002671 | GA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 2163877945 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sentry Anesthesia Management, LLC
Practice addresses (Care Compare)
126 US Hwy 280 W
Americus, GA 31719-8645
Phone (229) 924-6011
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN316457 | GA | MD | Certified Registered Nurse Anesthetist |
| AP61189448 | WA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sentry Anesthesia Management, LLC | Current | Accepting new patients | |
| Phoebe Physician Group, Inc | Past | Accepting new patients |
Locations
126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011
2548 Weems Rd
Columbus, GA 31909
Phone (404) 265-4000
6262 Veterans Pkwy
Columbus, GA 31909
Phone (706) 494-3071
710 Center St
Columbus, GA 31901
Phone (706) 571-1000
1514 Vernon Rd
Lagrange, GA 30240
Phone (706) 812-2369
Organizations & group practices 2
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.
-
- Clinic/Center
- Albany, GA
- NPI 1487899464
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709078400000",
"number": "1407428790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6600 VAN AALST BLVD",
"city": "FORT MOORE",
"state": "GA",
"postal_code": "319052102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6600 VAN AALST BLVD",
"city": "FORT MOORE",
"state": "GA",
"postal_code": "319052102",
"telephone_number": "762-408-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "BRANDON",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-07-15",
"last_updated": "2024-02-28",
"certification_date": "2024-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "GA",
"license": "RN316457",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WA",
"license": "AP61189448",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Moore, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.