Shawn Douglas Brede, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Practice address

1615 Maple Lane
Ashland, WI 54806

Phone

(715) 682-4563

Fax

(715) 685-5108

NPI assigned

Mar 14, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Superior Anesthesia Associates LTD

  • Pain Medicine (Anesthesiology) Physician
  • Ashland, WI
  • NPI 1780652883
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811965965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1547",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "65302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 MAPLE LANE",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "54806",
            "telephone_number": "715-682-4563",
            "fax_number": "715-685-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREDE",
        "first_name": "SHAWN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4335770",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4449324",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Bowe, MSW
• John Michael Boyle, M.D.
• Ryan J Brang, MD
• Karla M. Braski, LCSW
• James Robert Bratley
• Marsha Ann Breeser
• Brittani Jean Brennan, DPT
• Patsy L Brilla
• Jacquelyn Christine Brown, RN
• Kenneth L. Buckwheat, CSAC

• Certified Registered Nurse Anesthetist in Ashland, WI
• Providers in Ashland, WI by specialty
• Certified Registered Nurse Anesthetist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.