Individual provider Active NPI

Paul Edward Brewer, CRNA

  • Certified Registered Nurse Anesthetist
  • Terre Haute, IN
National Provider Identifier
1487707147
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
041-354753 Issued in IL
Practice address
7N the Meadows Shopping Center
Terre Haute, IN 47803-2373
Phone
(812) 237-0211
Fax
(812) 237-0182
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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 041-354753 IL Primary

Addresses

Primary practice location

7N the Meadows Shopping Center
Terre Haute, IN 47803-2373

Mailing address

PO Box 3169
Terre Haute, IN 47803-0169
Phone (812) 237-0211

Other identifiers 1

IdentifierTypeStateIssuer
2001001050MedicaidIN

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
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
041-354753ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Windy City Anesthesia PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Windy City Anesthesia PC Nurse Anesthetist, Certified Registered Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1487707147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3169",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478030169",
            "telephone_number": "812-237-0211",
            "fax_number": "812-237-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7N THE MEADOWS SHOPPING CENTER",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478032373",
            "telephone_number": "812-237-0211",
            "fax_number": "812-237-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "PAUL",
        "middle_name": "EDWARD",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "041-354753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2001001050",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.