Individual provider Active NPI

Brandon Boyd

  • Certified Registered Nurse Anesthetist
  • Bemidji, MN
National Provider Identifier
1467926691
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2299 Issued in MN
Practice address
1300 Anne St NW
Bemidji, MN 56601-5103
Phone
(218) 333-5000
NPI assigned
Jan 22, 2019
Last updated
Feb 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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 2299 MN Primary

Addresses

Primary practice location

1300 Anne St NW
Bemidji, MN 56601-5103

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

442 Foxtail Dr
West Fargo, ND 58078-7964
Phone (701) 214-8401

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240124000981 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022351626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians

Practice addresses (Care Compare)

2811 Tieton Dr
Yakima, WA 98902-3761
Phone (509) 575-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2299MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Memorial Physicians CurrentSince Jan 15, 2024 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Jan 15, 2024 Accepting new patients

Locations

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1467926691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ANNE ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015103",
            "telephone_number": "218-333-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "442 Foxtail Dr",
            "address_purpose": "LOCATION",
            "city": "West Fargo",
            "state": "ND",
            "postal_code": "580787964",
            "country_code": "US",
            "telephone_number": "701-214-8401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYD",
        "first_name": "BRANDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-22",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "2299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.