Individual provider Active NPI

Roxanne Brault

  • Certified Registered Nurse Anesthetist
  • Franklin, WI
National Provider Identifier
1831537679
Registry record updated Jun 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
67930-30 Issued in WI
Practice address
7929 S 66TH St
Franklin, WI 53132-9281
Phone
(414) 425-2191
NPI assigned
Jun 13, 2013
Last updated
Jun 13, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2013

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 67930-30 WI Primary

Addresses

Primary practice location

7929 S 66TH St
Franklin, WI 53132-9281

Mailing address

7929 S 66TH St
Franklin, WI 53132-9281
Phone (414) 425-2191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130724000884 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608017231 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67930-30WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Partners Services, S.C. CurrentSince Dec 1, 2014 Accepting new patients

Locations

2801 W Kinnickinnic River Pkwy
Ste 1030
Milwaukee, WI 53215
Phone (414) 649-5200

2801 W Kinnickinnic River Pkwy
Ste 1080
Milwaukee, WI 53215
Phone (414) 908-6506

88948 Box
Milwaukee, WI 53288

2424 S 90th St
Ste 418
West Allis, WI 53227
Phone (262) 970-7825

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1831537679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7929 S 66TH ST",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531329281",
            "telephone_number": "414-425-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7929 S 66TH ST",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531329281",
            "telephone_number": "414-425-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAULT",
        "first_name": "ROXANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-13",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "67930-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.