NPIMap

Individual provider Active NPI

Branden Joaquin Sibley

  • Certified Registered Nurse Anesthetist
  • Canton, OH
National Provider Identifier
1760930572
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.019337 Issued in OH
Practice address
6889 Wales Crossing St NW Apt D
Canton, OH 44720-5383
Phone
(330) 398-8609
NPI assigned
Sep 21, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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 APRN.CRNA.019337 OH Primary

Addresses

Primary practice location

6889 Wales Crossing St NW Apt D
Canton, OH 44720-5383

Mailing address

6889 Wales Crossing St NW Apt D
Canton, OH 44720-5383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161128002444 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739468216 Reassigns benefits to 2 organizations
I20180529000820 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739468216 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians

Practice addresses (Care Compare)

300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone (843) 347-7111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CRNA.019337OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 4, 2019 Accepting new patients
Ohio Anesthesia Group, Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 27, 2017 Accepting new patients
Northstar Anesthesia of Ohio LLC CurrentSince Oct 24, 2016 Accepting new patients
Beach Anesthesia, LLC CurrentSince Mar 5, 2018 Accepting new patients
Atlantic Coast Anesthesia Services P.C. Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2023 Accepting new patients

Locations

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

2615 E High St
Springfield, OH 45505
Phone (888) 861-3994

109 Blarney Dr
Columbia, SC 29223
Phone (803) 865-8200

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

1021 Cipriana Dr
Ste 100
Myrtle Beach, SC 29572
Phone (843) 449-7885

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

Organizations & group practices 5

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1760930572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6889 WALES CROSSING ST NW APT D",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447205383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6889 WALES CROSSING ST NW APT D",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447205383",
            "telephone_number": "330-398-8609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIBLEY",
        "first_name": "BRANDEN",
        "middle_name": "JOAQUIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-21",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.019337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.