Active NPI
Bradley Patrick, CRNA, DNP, MBA, MS
- Certified Registered Nurse Anesthetist
- Willits, CA
National Provider Identifier
1508948100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R051320
- Practice address
- 1 Madrone St
Willits, CA 95490-4225 - Phone
- (707) 456-3100
- NPI assigned
- Oct 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R051320 | ME | Primary |
Addresses
Primary practice location
1 Madrone St
Willits, CA 95490-4225
Mailing address
1724 Emerson Street
Unit #1
Denver, CO 80218
Phone (612) 367-7474
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ME-1670 | Other | ME | MAINE MEDICARE |
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, Master of Business Administration, Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Anesthesiology Medical Group, PA | Past | Accepting new patients | |
| Anesthesia Associates of the Rockies LLC | Past | Accepting new patients | |
| Mercy Tyler Health Systems | Past | Accepting new patients | |
| Kennebec Anesthesia Associates, P.a. | Past | Accepting new patients | |
| Mercy Tyler Hospital | Past | Accepting new patients |
Organizations & group practices 5
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.
-
- Anesthesiology Physician
- Lakewood, CO
- NPI 1962739003
-
- Anesthesiology Physician
- Brunswick, ME
- NPI 1467438408
-
- Anesthesiology Physician
- Augusta, ME
- NPI 1992789184
-
- Surgery Physician
- Tunkhannock, PA
- NPI 1881616985
-
- General Acute Care Hospital
- Tunkhannock, PA
- NPI 1386667533
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498521600000",
"number": "1508948100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1724 EMERSON STREET",
"address_2": "UNIT #1",
"city": "DENVER",
"state": "CO",
"postal_code": "80218",
"telephone_number": "612-367-7474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MADRONE ST",
"city": "WILLITS",
"state": "CA",
"postal_code": "954904225",
"telephone_number": "707-456-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRICK",
"first_name": "BRADLEY",
"name_prefix": "Dr.",
"credential": "CRNA, DNP, MBA, MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2017-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "ME",
"license": "R051320",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAINE MEDICARE",
"identifier": "ME-1670",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Willits, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.