Individual provider Active NPI

Brent Edward Earwood, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, TN
National Provider Identifier
1487651402
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN09716 Issued in TN
Practice address
17C Brentshire Square
Jackson, TN 38305-2273
Phone
(731) 664-1717
Fax
(731) 664-7114
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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 APN09716 TN Primary

Addresses

Primary practice location

17C Brentshire Square
Jackson, TN 38305-2273

Mailing address

17C Brentshire Square
Jackson, TN 38305-2273
Phone (731) 664-1717

Other practice location 1

5001 E Main St
Erin, TN 37061-4115
Phone (931) 289-4211

Other practice location 2

2545 N Washington Ave
Brownsville, TN 38012-1610
Phone (931) 289-4211

Other practice location 3

200 W Church St
Lexington, TN 38351-2038
Phone (731) 968-3646

Other identifiers 2

IdentifierTypeStateIssuer
3622515MedicaidTN
3622511MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101216000938 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 3375739667 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17 C Brentshire SQ
Jackson, TN 38305-2203

17 C Brentshire SQ
Jackson, TN 38305-2273

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
74.15
Promoting interoperability
77
Improvement activities
40
Cost
78.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APN09716TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Anesthesia, PC Nurse Anesthetist, Certified Registered CurrentSince Jun 5, 2000 Accepting new patients
Shamrock Community Hospital Inc CurrentSince Aug 1, 2022 Accepting new patients
Shamrock Community Hospital Inc. CurrentSince Aug 1, 2022 Accepting new patients
Anesthesiology Consultants Exchange, PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Dr. Dennis W. Wilson Past Accepting new patients

Locations

2545 N Washington Ave
Brownsville, TN 38012
Phone (731) 307-3777

5001 E Main St
Erin, TN 37061
Phone (336) 944-6420

36 Brentshire Sq
Jackson, TN 38305
Phone (501) 664-1717

17 Brentshire Sq
Ste C
Jackson, TN 38305
Phone (731) 664-1717

36 Brentshire Sq
Ste A1
Jackson, TN 38305

200 W Church St
Lexington, TN 38351
Phone (731) 968-1812

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1487651402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17C BRENTSHIRE SQUARE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052273",
            "telephone_number": "731-664-1717",
            "fax_number": "731-664-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17C BRENTSHIRE SQUARE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052273",
            "telephone_number": "731-664-1717",
            "fax_number": "731-664-7114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5001 E Main St",
            "address_purpose": "LOCATION",
            "city": "Erin",
            "state": "TN",
            "postal_code": "370614115",
            "country_code": "US",
            "telephone_number": "931-289-4211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2545 N Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Brownsville",
            "state": "TN",
            "postal_code": "380121610",
            "country_code": "US",
            "telephone_number": "931-289-4211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 W Church St",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "TN",
            "postal_code": "383512038",
            "country_code": "US",
            "telephone_number": "731-968-3646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EARWOOD",
        "first_name": "BRENT",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN09716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3622515",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3622511",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.

Verify at the official NPI Registry.