Bradley Daniel Jackson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

ARNP9312860 Issued in FL

Practice address

4901 Grande Dr
Pensacola, FL 32504-5935

Phone

(850) 477-7042

Fax

(850) 474-9060

NPI assigned

Feb 10, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

D.W. McMillan Memorial HospitalGroup PAC ID 3072558378, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• D W McMillan Memorial Hospital Hospital, Brewton, AL, CCN 010099

Merit-based Incentive Payment System (MIPS)

Final score

81.54 of 100Reported as group

Quality

51.78

Promoting interoperability

100

Improvement activities

40

Cost

78.35

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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.

• DW McMillan Memorial Hospital

  • Certified Registered Nurse Anesthetist
  • Brewton, AL
  • NPI 1033309125

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Vivid Pathology PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Pensacola, FL
  • NPI 1760738611
  NPD
• D.W. McMillan Memorial Hospital

  • Multi-Specialty Clinic/Center
  • Brewton, AL
  • NPI 1679196927
  NPD
• DW McMillan Memorial Hospital

  • Cardiovascular Disease Physician
  • Brewton, AL
  • NPI 1063612851
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• D. W. McMillan Memorial Hospital

  • General Acute Care Hospital
  • Brewton, AL
  • NPI 1609811538
  Care Compare affiliation

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

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1578869475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BELLEVILLE AVE",
            "city": "BREWTON",
            "state": "AL",
            "postal_code": "364261306",
            "telephone_number": "251-809-8429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 GRANDE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045935",
            "telephone_number": "850-477-7042",
            "fax_number": "850-474-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRADLEY",
        "middle_name": "DANIEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-10",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9312860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "592-13562",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "G00ME",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00959140",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126061",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003243800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Safwan Jaalouk, MD
• Steven Darryl Jabaley, MD
• Alexander Bishop Jackson, PHARM.D.
• Andrea Jackson
• Beverly High Jackson, DPH
• Charlotte Jackson
• Daniel Jackson
• Debra Ann Jackson, DC
• Erin Audrey Marie Jackson, M.D
• Jacqueline Marie Jackson, ARNP

• Certified Registered Nurse Anesthetist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.