Active NPI
Randall Watson Brady, CRNA
- Certified Registered Nurse Anesthetist
- Miami, OK
National Provider Identifier
1902875479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R0033098
- Practice address
- 200 2ND Ave SW
Miami, OK 74354-6830 - Phone
- (918) 542-6611
- Fax
- (918) 787-3635
- NPI assigned
- Mar 16, 2006
- Last updated
- Apr 5, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R0033098 | OK | Primary |
Addresses
Primary practice location
200 2ND Ave SW
Miami, OK 74354-6830
Mailing address
5300 N Independence Ave
280
Oklahoma City, OK 73112-5556
Phone (918) 542-6611
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100786990A | Medicaid | OK | |
| 200468380N | Medicaid | OK | |
| 500156500 | Medicaid | MO | |
| 911329803 | Medicaid | MO |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0033098 | OK | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brady's Home Health Care,Inc | Past | Accepting new patients |
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.
-
- Durable Medical Equipment & Medical Supplies
- Miami, OK
- NPI 1417983842
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491350400000",
"number": "1902875479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5300 N INDEPENDENCE AVE",
"address_2": "280",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731125556",
"telephone_number": "918-542-6611",
"fax_number": "918-787-3635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 2ND AVE SW",
"city": "MIAMI",
"state": "OK",
"postal_code": "743546830",
"telephone_number": "918-542-6611",
"fax_number": "918-787-3635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADY",
"first_name": "RANDALL",
"middle_name": "WATSON",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-16",
"last_updated": "2017-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OK",
"license": "R0033098",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100786990A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200468380N",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500156500",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "911329803",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.