Active NPI
Bronwyn Southwell, M.D.
- Anesthesiology Physician
- Minneapolis, MN
National Provider Identifier
1508155847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 4301110903
- Practice address
- 909 Fulton St SE
Minneapolis, MN 55455-4800 - Phone
- (612) 672-7422
- NPI assigned
- Apr 6, 2011
- Sex
- Female
- 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 | 4301110903 | MI | Primary |
Addresses
Primary practice location
909 Fulton St SE
Minneapolis, MN 55455-4800
Mailing address
909 Fulton St SE
Minneapolis, MN 55455-4800
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301110903 | MI | MD | Anesthesiology Physician |
Interoperability endpoints
- bsouthwell404497@fairview.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495756800000",
"number": "1508155847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 FULTON ST SE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554554800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 FULTON ST SE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554554800",
"telephone_number": "612-672-7422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTHWELL",
"first_name": "BRONWYN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-06",
"last_updated": "2017-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MI",
"license": "4301110903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.