Active NPI
Bradley Gregg Hanebrink, D.O.
- Anesthesiology Physician
- Sheridan, WY
National Provider Identifier
1467544007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 5140A
- Practice address
- 1401 W 5TH St
Sheridan Memorial Hospital
Sheridan, WY 82801-2705 - Phone
- (307) 672-1000
- NPI assigned
- Sep 29, 2006
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 5140A | WY | Primary |
Addresses
Primary practice location
1401 W 5TH St
Sheridan Memorial Hospital
Sheridan, WY 82801-2705
Mailing address
PO Box 767
Sheridan, WY 82801-0767
Phone (307) 674-5123
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103008600 | Medicaid | WY | |
| 305980 | Other | WY | BCBS OF WYOMING |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5140A | WY | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211241600000",
"number": "1467544007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 767",
"city": "SHERIDAN",
"state": "WY",
"postal_code": "828010767",
"telephone_number": "307-674-5123",
"fax_number": "307-674-5230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 W 5TH ST",
"address_2": "SHERIDAN MEMORIAL HOSPITAL",
"city": "SHERIDAN",
"state": "WY",
"postal_code": "828012705",
"telephone_number": "307-672-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANEBRINK",
"first_name": "BRADLEY",
"middle_name": "GREGG",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-29",
"last_updated": "2008-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WY",
"license": "5140A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103008600",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF WYOMING",
"identifier": "305980",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sheridan, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.