Breanna Allender, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Wichita, KS
NPI 1669828505 · NPPES record last updated Jan 25, 2017
Key facts
- NPI
- 1669828505
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 557452 (KS)
- Practice address
- 929 N Saint Francis St
Wichita, KS 67214-3821 - Phone
- (316) 268-5000
- Fax
- (316) 291-4272
- NPI assigned
- May 10, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kansas Anesthesia Providers, LLC
Practice addresses (Care Compare)
1124 W 21St St
100 Andover Ambulatory Surgery Center
Andover, KS 67002-5500
Phone (316) 440-3200
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161011002236 | KS | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 4587952395 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115426 | KS | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kansas Anesthesia Providers, LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
Locations
1124 W 21st St
#100
Andover, KS 67002
Phone (316) 440-3200
9300 E 29th St N
Ste 100
Wichita, KS 67226
Phone (316) 634-0404
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 115426 | KS | |
| Certified Registered Nurse Anesthetist | 367500000X | 557452 | KS | Yes |
Addresses
Primary practice location
929 N Saint Francis St
Wichita, KS 67214-3821
Mailing address
PO Box 2897
Wichita, KS 67201-2897
Phone (877) 649-7812
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669828505 | Other | KS | RR MEDICARE PTAN |
| 201142220A | Medicaid | KS |
Other names
- Breanna Renea Gross
Other providers in Wichita, KS
- Shawna Allen
- Steven Burton Allen
- Tracy Delois Allen
- Richard G Allenbach
- Stacy R Allenbach
- Allergy & Asthma Center
- Amy R Alley
- Bobbie Jo Alley
- James M Alley III
- Alliance Therapy LLC
All providers in Wichita, KS · Certified Registered Nurse Anesthetist in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.