Individual provider Active NPI

Bradley D Benton, CRNA

  • Certified Registered Nurse Anesthetist
  • Rhinelander, WI
National Provider Identifier
1720060064
Registry record updated Feb 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
131247 Issued in WI
Practice address
2251 N Shore Dr
Rhinelander, WI 54501-8360
Phone
(715) 361-4700
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2009

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 131247 WI Primary

Addresses

Primary practice location

2251 N Shore Dr
Rhinelander, WI 54501-8360

Mailing address

2251 N Shore Dr
Rhinelander, WI 54501-8360
Phone (715) 361-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040317001260 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305736919 Reassigns benefits to 2 organizations
I20080927000192 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305736919 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Ironwood Hospital and Clinics Inc 165 clinicians

Practice addresses (Care Compare)

N10561 Grandview LN
Ironwood, MI 49938-9622
Phone (906) 932-2525

N10561 Granview LN
Grand View Hospital
Ironwood, MI 49938-9622
Phone (906) 932-2525

N10565 Grandview LN Aspirus Ironwood
Aspirus Palliative Medicine Michi
Ironwood, MI 49938-9622
Phone (715) 843-1067

Hospital & facility affiliations

  • Aspirus Ironwood Hospital Hospital, Ironwood, MI, CCN 231333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
131247WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Medical Center Inc CurrentSince Jul 22, 2023 Accepting new patients
Aspirus Ironwood Hospital & Clinics, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Memorial Medical Center Inc CurrentSince Jul 22, 2023 Accepting new patients
Aspirus Ironwood Hospital & Clinics, Inc. Current Accepting new patients
Premier Spine Group, S.C. CurrentSince Aug 1, 2024 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

N10561 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500

N10565 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500

1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563

520 Vincent St
Stevens Point, WI 54481
Phone (715) 544-1774

200 Division St
Ste J
Stevens Point, WI 54481
Phone (715) 544-1774

Organizations & group practices 10

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.

Hospital & facility affiliations 6

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": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234915200000",
    "number": "1720060064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 N SHORE DR",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545018360",
            "telephone_number": "715-361-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 N SHORE DR",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545018360",
            "telephone_number": "715-361-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTON",
        "first_name": "BRADLEY",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2009-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "131247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rhinelander, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; 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.