Bradley Wierda, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

C02770 Issued in AR

Practice address

2710 Rife Medical Lane
Anesthesia Dept
Rogers, AR 72758-1452

Phone

(479) 338-8000

Fax

(479) 338-3056

NPI assigned

Dec 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in AR, IA2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renew Medical Group of Arkansas LTDGroup PAC ID 3173056298, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bwierda1075757@direct.unitypoint.org

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.

• Renew Medical Group of Arkansas LTD

  • Anesthesiology Physician
  • Fort Smith, AR
  • NPI 1215755947

  AR, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Anesthesia Services of Benton County PA

  • Anesthesiology Physician
  • Rogers, AR
  • NPI 1013084482

  AR

  Medicare reassignment NPD
• Northwest Iowa Anesthesia Associates

  • Certified Registered Nurse Anesthetist
  • Spencer, IA
  • NPI 1871568493

  IA, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Professional Lone Star Anesthesia Associates, P

  • Certified Registered Nurse Anesthetist
  • Ennis, TX
  • NPI 1215087804

  Nurse Anesthetist, Certified Registered

  NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Ennis Anesthesia Associates PLLC

  • Anesthesiology Physician
  • Ennis, TX
  • NPI 1659328730

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

• Mercy Hospital Rogers

  • General Acute Care Hospital
  • Rogers, AR
  • NPI 1316902414

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1770560518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 507",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450507",
            "telephone_number": "913-647-4100",
            "fax_number": "913-647-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 RIFE MEDICAL LANE",
            "address_2": "ANESTHESIA DEPT",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-338-8000",
            "fax_number": "479-338-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIERDA",
        "first_name": "BRADLEY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C02770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770560518",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179913001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200347410A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAR",
            "identifier": "5V232",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR",
            "identifier": "P00755473",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison White
• Trinity Talyn White
• Melissa Lee Whiting
• Lighla Whitson, M.S., CF-SLP
• Michelle Cherie Wieneke, APRN
• Jeanie Marie Wiertzema, P.T.
• Angela Wieser
• Shelby Wigginton
• William C. Wigington, D.O.
• Catherine Lynnette Wikoff, MD

• All providers in Rogers, AR
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.