Individual provider Active NPI

Brenda Rutledge-Hilburn, CRNA

  • Certified Registered Nurse Anesthetist
  • Monroe, LA
National Provider Identifier
1508975517
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP03239 Issued in LA
Practice address
2108 Island Dr
Monroe, LA 71201-2521
Phone
(318) 376-1312
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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 AP03239 LA Primary

Addresses

Primary practice location

2108 Island Dr
Monroe, LA 71201-2521

Mailing address

2108 Island Dr
Monroe, LA 71201-2521
Phone (318) 376-1312

Other identifiers 1

IdentifierTypeStateIssuer
1544001MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041112000081 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0143284968 Reassigns benefits to 1 organization
I20200928001337 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0143284968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smso Anesthesia, LLCGroup PAC ID 7012970627, 49 clinicians

Practice addresses (Care Compare)

2408 Broadmoor Blvd
Monroe, LA 71201-2994
Phone (318) 812-1760

309 Jackson St
Monroe, LA 71201-7407
Phone (318) 812-1760

Hospital & facility affiliations

  • Fmol Health St Francis Hospital, Monroe, LA, CCN 190125
  • Monroe Surgical Hospital Hospital, Monroe, LA, CCN 190245

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP03239LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Oct 1, 2020 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Oct 1, 2020 Accepting new patients
Twin City Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Fontenot & McIntosh, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Twin City Anesthesia Past Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

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.

Hospital & facility affiliations 2

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1508975517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 ISLAND DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712012521",
            "telephone_number": "318-376-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 ISLAND DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712012521",
            "telephone_number": "318-376-1312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLEDGE-HILBURN",
        "first_name": "BRENDA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP03239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1544001",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.