Individual provider Active NPI

Carl Brueggemann Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Florence, KY
National Provider Identifier
1649294828
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3001240 Issued in KY
Practice address
8718 Signal Pointe CT
Florence, KY 41042-8405
Phone
(859) 371-6419
NPI assigned
Jul 27, 2006
Last updated
Dec 6, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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 3001240 KY Primary

Addresses

Primary practice location

8718 Signal Pointe CT
Florence, KY 41042-8405

Mailing address

8718 Signal Pointe CT
Florence, KY 41042-8405
Phone (859) 371-6419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041019000937 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 9436110970 Reassigns benefits to 1 organization
I20070924000307 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 9436110970 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Endoscopy Center of West Central Ohio, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 12, 2021 Accepting new patients
Clinical Colleagues LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 22, 2007 Accepting new patients
Resource Anesthesia Highlands Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 5, 2019 Accepting new patients
Cumberland Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients
Laser Spine Institute, LLC Past Accepting new patients
Riverhills Anesthesia Associates Past Accepting new patients

Locations

33151 Collection Ctr Dr
Chicago, IL 60693

1 Elizabeth Pl
Dayton, OH 45417
Phone (937) 424-8200

1275 N High St
Hillsboro, OH 45133
Phone (937) 393-5503

2793 Shawnee Rd
Ste 1
Lima, OH 45806

2793 Shawnee Rd
Lima, OH 45806
Phone (419) 204-1501

1250 S Washington St
Van Wert, OH 45891
Phone (419) 232-2077

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1386288000000",
    "number": "1649294828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8718 SIGNAL POINTE CT",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410428405",
            "telephone_number": "859-371-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8718 SIGNAL POINTE CT",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410428405",
            "telephone_number": "859-371-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUEGGEMANN",
        "first_name": "CARL",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3001240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.