Individual provider Active NPI

Cody Brandes

  • Certified Registered Nurse Anesthetist
  • Champaign, IL
National Provider Identifier
1861288367
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28252655A Issued in IN
Practice address
2005 Moreland Blvd
Champaign, IL 61822-1426
Phone
(812) 907-0183
NPI assigned
Apr 19, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28252655A IN
Certified Registered Nurse Anesthetist 367500000X 28252655A IN Primary

Addresses

Primary practice location

2005 Moreland Blvd
Champaign, IL 61822-1426

Mailing address

2005 Moreland Blvd
Champaign, IL 61822-1426

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250625003234 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739691635 Reassigns benefits to 1 organization
I20251205000128 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739691635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Premier Anesthesia Associates, LLCGroup PAC ID 2062498140, 10 clinicians
Clinical Colleagues IncGroup PAC ID 8729011333, 170 clinicians

Practice addresses (Care Compare)

321 Mitchell Ave
Batesville, IN 47006-8909
Phone (812) 934-6624

500 John Deere Rd
Moline, IL 61265-6892
Phone (844) 937-1810

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28252655AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Colleagues Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 20, 2025 Accepting new patients
Premier Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2025 Accepting new patients
Clinical Colleagues Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 20, 2025 Accepting new patients

Locations

695 N Kellogg St
Galesburg, IL 61401
Phone (309) 343-8131

500 John Deere Rd
Moline, IL 61265
Phone (309) 779-2840

321 Mitchell Ave
Batesville, IN 47006
Phone (812) 933-5018

1900 Chester Blvd
Richmond, IN 47374
Phone (765) 962-2020

Organizations & group practices 3

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 2

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": "1745020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1861288367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 MORELAND BLVD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 MORELAND BLVD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221426",
            "telephone_number": "812-907-0183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDES",
        "first_name": "CODY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-19",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28252655A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28252655A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.