Individual provider Active NPI

Bradley C. Harville, CRNA

  • Certified Registered Nurse Anesthetist
  • Tyler, TX
National Provider Identifier
1457323586
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
649837 Issued in TX
Practice address
800 E Dawson St
Tyler, TX 75701-2036
Phone
(903) 606-4522
NPI assigned
Feb 2, 2006
Last updated
May 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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 649837 TX Primary

Addresses

Primary practice location

800 E Dawson St
Tyler, TX 75701-2036

Mailing address

PO Box 452319
Sunrise, FL 33345-2319

Other practice location 1

1613 Harrison Pkwy
#200
Sunrise, FL 33323-2853
Phone (954) 838-2371

Other practice location 2

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000

Other identifiers 3

IdentifierTypeStateIssuer
1O6211OtherTXMEDICARE
165123401MedicaidTX
165123408MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040615001428 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951385129 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medicine AssociatesGroup PAC ID 7719979509, 590 clinicians

Practice addresses (Care Compare)

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
649837TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Spine Team Texas, PA CurrentSince Mar 1, 2018 Accepting new patients
Christus Good Shepherd Medical Center CurrentSince Feb 25, 2021 Accepting new patients
Community Medicine Associates CurrentSince Sep 21, 2023 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Nov 1, 2023 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Nov 1, 2023 Accepting new patients
Quitman Hospital LLC CurrentSince Jan 15, 2020 Accepting new patients
Northstar Anesthesia II PA Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2018 Accepting new patients
Spine Team Texas, PA CurrentSince Mar 1, 2018 Accepting new patients
Spine Team Texas PA Current Accepting new patients
Quitman Hospital LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 15, 2020 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Apr 26, 2021 Accepting new patients
University of Texas Health Science Center at San Antonio Current Accepting new patients
Christus Good Shepherd Medical Center Nurse Anesthetist, Certified Registered CurrentSince Feb 25, 2021 Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Oct 11, 2014 Accepting new patients

Locations

2000 E Lamar Blvd
Ste 400
Arlington, TX 76006
Phone (817) 861-3994

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

900 8th Ave
Ft Worth, TX 76104
Phone (817) 336-2100

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

1900 Hospital Blvd
Gainesville, TX 76240
Phone (940) 612-8150

1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

811 S Washington Ave
Marshall, TX 75670
Phone (903) 315-1488

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

117 N Winnsboro St
Quitman, TX 75783
Phone (903) 763-4505

3142 Horizon Rd
Ste 100
Rockwall, TX 75032
Phone (682) 651-1908

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

1545 E Southlake Blvd
Ste 100
Southlake, TX 76092

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Organizations & group practices 14

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.

View all 14

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1457323586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 452319",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333452319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E DAWSON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012036",
            "telephone_number": "903-606-4522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1613 Harrison Pkwy",
            "address_2": "#200",
            "address_purpose": "LOCATION",
            "city": "Sunrise",
            "state": "FL",
            "postal_code": "333232853",
            "country_code": "US",
            "telephone_number": "954-838-2371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4502 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782294402",
            "country_code": "US",
            "telephone_number": "210-358-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARVILLE",
        "first_name": "BRADLEY",
        "middle_name": "C.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "649837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1O6211",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165123401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165123408",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.

Verify at the official NPI Registry.