Individual provider Active NPI

Brenda G. Hensley, CRNA

  • Certified Registered Nurse Anesthetist
  • South Charleston, WV
National Provider Identifier
1588688071
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
047230 Issued in WV
Practice address
4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone
(304) 766-3600
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 047230 WV Primary
Certified Registered Nurse Anesthetist 367500000X 05000 OH

Addresses

Primary practice location

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311

Mailing address

331 Laidley St
Suite 606
Charleston, WV 25301-1619
Phone (304) 344-0096

Other identifiers 3

IdentifierTypeStateIssuer
001720710OtherWVWV BLUE CROSS PROVIDER #
550696369OtherWVWV WORKERS PROVIDER #
0069102000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041109001268 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214990316 Reassigns benefits to 1 organization
I20170823000261 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214990316 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beach Anesthesia, LLCGroup PAC ID 6103924014, 91 clinicians

Practice addresses (Care Compare)

109 Blarney Dr
Columbia, SC 29223-6244
Phone (803) 865-8200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05000OHMDCertified Registered Nurse Anesthetist
047230WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jul 3, 2018 Accepting new patients
Beach Anesthesia, LLC CurrentSince Jan 1, 2021 Accepting new patients
Under Anesthesia CurrentSince Aug 9, 2022 Accepting new patients
Concordia Anesthesiology, Inc CurrentSince May 1, 2022 Accepting new patients
Center for Pain Relief, Inc. Past Accepting new patients
Mid-Atlantic Anesthesia Consultants, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Professional Anesthesia Service,Inc. Past Accepting new patients

Locations

106 Ellett Rd
Chapin, SC 29036
Phone (803) 941-8096

109 Blarney Dr
Columbia, SC 29223
Phone (803) 865-8200

5 Memorial Medical Ct
Greenville, SC 29605
Phone (864) 272-3409

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

391 Serpentine Dr
Ste 200
Spartanburg, SC 29303
Phone (864) 583-6381

Organizations & group practices 8

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1588688071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 LAIDLEY ST",
            "address_2": "SUITE 606",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011619",
            "telephone_number": "304-344-0096",
            "fax_number": "304-342-4725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "telephone_number": "304-766-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSLEY",
        "first_name": "BRENDA",
        "middle_name": "G.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "047230",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "05000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV BLUE CROSS PROVIDER #",
            "identifier": "001720710",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV WORKERS PROVIDER #",
            "identifier": "550696369",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0069102000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; 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.