Individual provider Active NPI

Donna L. Brunette, CRNA

  • Specialist
  • Spartanburg, SC
National Provider Identifier
1760445803
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
R67114 Issued in SC
Practice address
720 N Pine St
Spartanburg, SC 29303-3127
Phone
(864) 560-5822
Fax
(864) 592-0586
NPI assigned
Apr 10, 2006
Last updated
Oct 16, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X R67114 SC Primary

Addresses

Primary practice location

720 N Pine St
Spartanburg, SC 29303-3127

Mailing address

PO Box 4718
Spartanburg, SC 29305-4718
Phone (864) 592-0586

Other identifiers 1

IdentifierTypeStateIssuer
AN0868MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R67114SCMDSpecialist
19155SCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ambulatory Anesthesia, LLC Specialist Past Accepting new patients
Precision Anesthesia, LLC Specialist Past Accepting new patients
Crescent Anesthesia Associates Past Accepting new patients

Organizations & group practices 3

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1760445803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4718",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293054718",
            "telephone_number": "864-592-0586",
            "fax_number": "864-592-0586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N PINE ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033127",
            "telephone_number": "864-560-5822",
            "fax_number": "864-592-0586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNETTE",
        "first_name": "DONNA",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "R67114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN0868",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.