Individual provider Active NPI

Bryan James Chappuis, CRNA

  • Certified Registered Nurse Anesthetist
  • Longview, TX
National Provider Identifier
1902840515
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
445555 Issued in TX
Practice address
17 Stonegate Dr
Longview, TX 75601-3659
Phone
(903) 234-9212
NPI assigned
Jun 15, 2006
Last updated
Jan 24, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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 445555 TX Primary

Addresses

Primary practice location

17 Stonegate Dr
Longview, TX 75601-3659

Mailing address

17 Stonegate Dr
Longview, TX 75601-3659

Other identifiers 1

IdentifierTypeStateIssuer
109945904MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1902840515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 STONEGATE DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756013659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 STONEGATE DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756013659",
            "telephone_number": "903-234-9212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPPUIS",
        "first_name": "BRYAN",
        "middle_name": "JAMES",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "445555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109945904",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; 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.