Antebellum Anesthesia, LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

ARNP9216040 Issued in FL

Legal business name

ANTEBELLUM ANESTHESIA, LLC

Practice address

202 Doctors Dr
Panama City, FL 32405-4454

Phone

(850) 896-8799

NPI assigned

Apr 8, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Amanda Rena Brown, DNAP, CRNANPI 1235261595

Title

Owner

Phone

(850) 896-8799

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Rena Brown, CRNA

  • Certified Registered Nurse Anesthetist
  • Panama City, FL
  • NPI 1235261595

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD Authorized official
• Kalyn Saunders, CRNA

  • Certified Registered Nurse Anesthetist
  • Destin, FL
  • NPI 1720401102

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Angela S Lane, CRNA

  • Certified Registered Nurse Anesthetist
  • Martin, TN
  • NPI 1801923727

  FL, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

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

{
    "created_epoch": "1491609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502668800000",
    "number": "1770016503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 W 23RD ST",
            "address_2": "#284",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053922",
            "telephone_number": "850-896-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 DOCTORS DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054454",
            "telephone_number": "850-896-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTEBELLUM ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-08",
        "last_updated": "2017-08-14",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "RENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-896-8799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNAP, CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9216040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000503500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1235261595",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Certified Registered Nurse Anesthetist in Panama City, FL
• Providers in Panama City, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.