Individual provider Active NPI

Brad Church, CRNA

  • Certified Registered Nurse Anesthetist
  • Gettysburg, PA
National Provider Identifier
1912985607
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN356752L Issued in PA
Practice address
147 Gettys St
Gettysburg, PA 17325-2534
Phone
(717) 337-4168
Fax
(717) 337-4318
NPI assigned
Jan 4, 2006
Last updated
Mar 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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 RN356752L PA Primary

Addresses

Primary practice location

147 Gettys St
Gettysburg, PA 17325-2534

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 337-4168

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

State licenses

LicenseStateTypeSpecialty
RN356752LPAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of York PA Inc Nurse Anesthetist, Certified Registered 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.

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1912985607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-337-4168",
            "fax_number": "717-337-4318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 GETTYS ST",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "173252534",
            "telephone_number": "717-337-4168",
            "fax_number": "717-337-4318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "BRAD",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN356752L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gettysburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.