Individual provider Active NPI

Brady Thompson, CRNA

  • Certified Registered Nurse Anesthetist
  • Tyler, TX
National Provider Identifier
1649570615
Registry record updated Mar 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
736869 Issued in TX
Practice address
800 E Dawson St
Tyler, TX 75701-2036
Phone
(903) 531-4500
NPI assigned
Oct 25, 2010
Last updated
Mar 5, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 736869 TX
Registered Nurse 163W00000X 121651 LA
Certified Registered Nurse Anesthetist 367500000X 736869 TX Primary

Addresses

Primary practice location

800 E Dawson St
Tyler, TX 75701-2036

Mailing address

PO Box 841656
Dallas, TX 75284-1656
Phone (903) 531-5000

Other identifiers 5

IdentifierTypeStateIssuer
75-0818167-015OtherTXTRICARE
220429902MedicaidTX
8174UJOtherTXBCBS
P01408239OtherTXRAILROAD MEDICARE
220429901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110509000535 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456537471 Reassigns benefits to 7 organizations
I20150728005356 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456537471 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novus Louisiana Medical Professional CorporationGroup PAC ID 5395194880, 23 clinicians
Northstar Anesthesia III PAGroup PAC ID 0042630501, 393 clinicians
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians
Medical Center AnesthesiologistsGroup PAC ID 6608814843, 13 clinicians

Practice addresses (Care Compare)

1500 Line Ave
Suite 206
Shreveport, LA 71101-4649
Phone (318) 213-3800

2901 4TH St
Longview, TX 75605-5128
Phone (903) 232-3606

3315 S Alameda St
Corpus Christi, TX 78411-1820
Phone (214) 687-0001

409 Cottage Rd
Carthage, TX 75633-1466
Phone (903) 693-3841

708 N Ashley Ridge Loop
Suite 400
Shreveport, LA 71106-7234
Phone (318) 300-3643

7400 Barlite Blvd
San Antonio, TX 78224-1308
Phone (210) 921-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
121651LAMDRegistered Nurse
736869TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 17, 2020 Accepting new patients
Christus Good Shepherd Medical Center CurrentSince Sep 1, 2017 Accepting new patients
Christus Health Ark-la-Tex CurrentSince Feb 9, 2024 Accepting new patients
Christus Health Ark-la-Tex Current Accepting new patients
Indep Anesthesia Services of la LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 2, 2025 Accepting new patients
Novus Louisiana Medical Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2023 Accepting new patients
Tandem Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2026 Accepting new patients
Northstar Anesthesia III PA Nurse Anesthetist, Certified Registered CurrentSince Jun 30, 2021 Accepting new patients
Christus Health Northern Louisiana CurrentSince Jul 5, 2024 Accepting new patients
Christus Health Ark-la-Tex CurrentSince Feb 9, 2024 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2022 Accepting new patients
Longview Medical Center LP Nurse Anesthetist, Certified Registered CurrentSince Jan 19, 2011 Accepting new patients
Medical Center Anesthesiologists CurrentSince Jun 1, 2015 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Dec 1, 2014 Accepting new patients
Longview Medical Center LP CurrentSince Jan 19, 2011 Accepting new patients
Christus Good Shepherd Medical Center Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2017 Accepting new patients
Christus Health Northern Louisiana Nurse Anesthetist, Certified Registered CurrentSince Jul 5, 2024 Accepting new patients
Grasshopper Anesthesia Services PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 12, 2022 Accepting new patients
North Caddo Anesthesia Billing Nurse Anesthetist, Certified Registered Past Accepting new patients
Laser & Cataract Center of Shreveport LLC Past Accepting new patients

Locations (25 of 29)

3220 N St NW
Washington, DC 20007
Phone (202) 338-6051

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

1455 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 300-3643

1500 Line Ave
Shreveport, LA 71101
Phone (318) 213-3754

1500 Line Ave
Ste 206
Shreveport, LA 71101
Phone (318) 213-3800

3217 Mabel St
Shreveport, LA 71103

445 Ashley Ridge Blvd
Shreveport, LA 71106
Phone (318) 869-1130

708 N Ashley Ridge Loop
Ste 400
Shreveport, LA 71106
Phone (318) 210-3315

14425 Falcon Head Blvd
#11
Austin, TX 78738
Phone (512) 900-1006

3080 College St
#T
Beaumont, TX 77701
Phone (409) 212-5002

409 Cottage Rd
Carthage, TX 75633
Phone (903) 693-3841

110 Shult Dr
Columbus, TX 78934
Phone (979) 493-7560

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

6949 Bryant Irvin Rd
Ste 110
Ft Worth, TX 76132
Phone (817) 332-1818

6800 N MacArthur Blvd
Irving, TX 75039
Phone (972) 969-2000

200 W Ollie St
Llano, TX 78643
Phone (325) 216-9199

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

703 E Marshall Ave
Ste 2000
Longview, TX 75601
Phone (903) 236-5300

811 S Washington Ave
Marshall, TX 75670
Phone (903) 315-1488

1204 N Mound St
Nacogdoches, TX 75961
Phone (936) 564-4611

3302 NE Stallings Dr
Nacogdoches, TX 75965
Phone (936) 564-2411

3610 N University Dr
Nacogdoches, TX 75965
Phone (936) 254-4703

4600 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (713) 853-9302

200 S Interstate 35
Pearsall, TX 78061
Phone (888) 250-2326

Organizations & group practices 20

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.

View all 20

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": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1649570615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841656",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752841656",
            "telephone_number": "903-531-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E DAWSON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012036",
            "telephone_number": "903-531-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "BRADY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-25",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "736869",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "121651",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "736869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-015",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220429902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8174UJ",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01408239",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220429901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; 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.