Individual provider Active NPI

Brittany A Outlaw, CRNA

  • Certified Registered Nurse Anesthetist
  • Dothan, AL
National Provider Identifier
1710256334
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-113632 Issued in AL
Practice address
1450 Ross Clark Cir
Dothan, AL 36301-4765
Phone
(334) 793-5105
Fax
(334) 671-5073
NPI assigned
Dec 28, 2011
Last updated
Dec 28, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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 1-113632 AL Primary

Addresses

Primary practice location

1450 Ross Clark Cir
Dothan, AL 36301-4765

Mailing address

1118 Ross Clark Cir
Suite 700
Dothan, AL 36301-3001
Phone (334) 793-5105

Other identifiers 1

IdentifierTypeStateIssuer
1-113632OtherALAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120124000879 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688841174 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Alabama School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dale Medical CenterGroup PAC ID 3476466327, 29 clinicians

Practice addresses (Care Compare)

126 Hospital Ave
Ozark, AL 36360-2018
Phone (334) 774-2601

126 Hospital Ave
Ozark, AL 36360-2080

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Laboratory Associates Current Accepting new patients
Dale Medical Center CurrentSince Jul 28, 2021 Accepting new patients
Houston County Healthcare Authority Nurse Anesthetist, Certified Registered Current Accepting new patients
Southern Alabama Surgery Center LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 15, 2020 Accepting new patients
Dale Medical Center Current Accepting new patients
Houston County Healthcare Authority CurrentSince Feb 6, 2018 Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Veronox Anesthesia, LLC CurrentSince May 1, 2022 Accepting new patients
Dale Medical Center Nurse Anesthetist, Certified Registered CurrentSince Jul 28, 2021 Accepting new patients
Anesthesia Consultants Medical Group PC Nurse Anesthetist, Certified Registered CurrentSince Jan 16, 2012 Accepting new patients
Medcore Associates, PLLC Current Accepting new patients
Dale Medical Center Past Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

1118 Ross Clark Cir
Ste 700
Dothan, AL 36301
Phone (334) 793-5105

1450 Ross Clark Cir
Dothan, AL 36301
Phone (334) 793-5105

2800 Ross Clark Cir
Dothan, AL 36301
Phone (334) 793-3411

2800 Ross Clark Cir
Ste 3
Dothan, AL 36301
Phone (334) 793-3411

201 E Watts St
Enterprise, AL 36330
Phone (334) 383-5474

400 N Edwards St
Enterprise, AL 36330
Phone (334) 347-0584

126 Hospital Ave
Ozark, AL 36360
Phone (334) 445-4803

218 Hospital Ave
Ste B
Ozark, AL 36360
Phone (334) 445-1025

Organizations & group practices 12

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.

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": "1325030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325030400000",
    "number": "1710256334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 ROSS CLARK CIR",
            "address_2": "SUITE 700",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013001",
            "telephone_number": "334-793-5105",
            "fax_number": "334-671-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363014765",
            "telephone_number": "334-793-5105",
            "fax_number": "334-671-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUTLAW",
        "first_name": "BRITTANY",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-28",
        "last_updated": "2011-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-113632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL LICENSE",
            "identifier": "1-113632",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.