Individual provider Active NPI

Bradley Keith Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • Montgomery, AL
National Provider Identifier
1811949555
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1071412 Issued in AL
Practice address
2105 East South Blvd
Montgomery, AL 36116
Phone
(334) 288-2100
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1071412 AL Primary
Certified Registered Nurse Anesthetist 367500000X 4049185 KY
Certified Registered Nurse Anesthetist 367500000X GAA-CRNA001829 GA
Certified Registered Nurse Anesthetist 367500000X APRN11046584 FL
Certified Registered Nurse Anesthetist 367500000X 0024196080 VA

Addresses

Primary practice location

2105 East South Blvd
Montgomery, AL 36116

Mailing address

PO Box 235022
Montgomery, AL 36123-5022
Phone (334) 386-2051

Other identifiers 2

IdentifierTypeStateIssuer
009966835MedicaidAL
051524132OtherALBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA, KY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040811000396 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385616283 Reassigns benefits to 3 organizations
I20241108001365 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385616283 Reassigns benefits to 2 organizations
I20260323002295 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385616283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
T J Samson Community HospitalGroup PAC ID 0648182600, 197 clinicians
Montgomery Anesthesia Associates, PCGroup PAC ID 9537153572, 51 clinicians
Premier Anesthesia of Montgomery PCGroup PAC ID 5799684148, 117 clinicians
Hospitalist Medicine Physicians of Georgia - TCS, PCGroup PAC ID 3971024910, 112 clinicians

Practice addresses (Care Compare)

1301 N Race St
Glasgow, KY 42141-3454
Phone (270) 651-4444

1725 Pine St
Montgomery, AL 36106-1109
Phone (334) 513-1173

2105 E S Blvd
Montgomery, AL 36116-2409
Phone (334) 286-3579

400 Taylor Rd
Montgomery, AL 36117-3512
Phone (334) 277-8330

710 Ctr St
Columbus, GA 31901-1527
Phone (706) 571-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1071412ALMDCertified Registered Nurse Anesthetist
APRN11046584FLMDCertified Registered Nurse Anesthetist
GAA-CRNA001829GAMDCertified Registered Nurse Anesthetist
4049185KYMDCertified Registered Nurse Anesthetist
0024196080VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sentry Anesthesia Management, LLC CurrentSince Aug 29, 2024 Accepting new patients
Hospitalist Medicine Physicians of Georgia - TCS, PC CurrentSince Jan 29, 2025 Accepting new patients
Coastal Healthcare Resources Inc Nurse Anesthetist, Certified Registered CurrentSince Oct 9, 2021 Accepting new patients
Premier Anesthesia of Montgomery PC Nurse Anesthetist, Certified Registered CurrentSince Jan 19, 2004 Accepting new patients
Anesthesia Network Services, LLC Past Accepting new patients

Locations

2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842

400 Taylor Rd
Montgomery, AL 36117
Phone (334) 213-6287

1501 Forest Ave
Montgomery, AL 36106
Phone (334) 265-3140

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

100 Frist Ct
Columbus, GA 31909
Phone (706) 494-2100

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

Organizations & group practices 7

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1811949555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235022",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235022",
            "telephone_number": "334-386-2051",
            "fax_number": "334-396-6929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 EAST SOUTH BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36116",
            "telephone_number": "334-288-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRADLEY",
        "middle_name": "KEITH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2026-07-13",
        "certification_date": "2026-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1071412",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "4049185",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "GAA-CRNA001829",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11046584",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024196080",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009966835",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "051524132",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.