NPIMap

Individual provider Active NPI

Brandie Danielle Berry, CRNA

  • Certified Registered Nurse Anesthetist
  • Louisville, KY
National Provider Identifier
1760713481
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3006323 Issued in KY
Practice address
1850 Bluegrass Ave
Anesthesia Department
Louisville, KY 40215-1161
Phone
(502) 361-6617
Fax
(502) 361-6637
NPI assigned
Jan 20, 2010
Last updated
Apr 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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 3006323 KY Primary

Addresses

Primary practice location

1850 Bluegrass Ave
Anesthesia Department
Louisville, KY 40215-1161

Mailing address

100 E Liberty St Ste 800
Louisville, KY 40202-1428
Phone (502) 361-6617

Other identifiers 2

IdentifierTypeStateIssuer
7100109380MedicaidKY
200975010AMedicaidIN

Other names 1

  • Brandie Wigginton Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100512000381 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8123156171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

201 Abraham Flexner Way
Suite 1200
Louisville, KY 40202-3481
Phone (502) 583-8383

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3006323KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
University Anesthesiology Associates PSC Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

1850 Bluegrass Ave
Louisville, KY 40215
Phone (502) 361-6000

201 Abraham Flexner Way
Ste 1200
Louisville, KY 40202
Phone (502) 583-8383

5100 Outer Loop
Louisville, KY 40219
Phone (502) 968-6226

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

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.

Hospital & facility affiliations 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1760713481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LIBERTY ST STE 800",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021428",
            "telephone_number": "502-361-6617",
            "fax_number": "502-361-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 BLUEGRASS AVE",
            "address_2": "ANESTHESIA DEPARTMENT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151161",
            "telephone_number": "502-361-6617",
            "fax_number": "502-361-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "BRANDIE",
        "middle_name": "DANIELLE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-20",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3006323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100109380",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200975010A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDIE",
            "last_name": "WIGGINTON",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; 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.