Individual provider Active NPI

Brooke Lund, CRNA

  • Certified Registered Nurse Anesthetist
  • Polson, MT
National Provider Identifier
1992860944
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
25758 Issued in MT
Practice address
6 13TH Ave E
Polson, MT 59860-5315
Phone
(406) 883-5377
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 25758 MT Primary

Addresses

Primary practice location

6 13TH Ave E
Polson, MT 59860-5315

Mailing address

6 13TH Ave E
Polson, MT 59860-5315
Phone (406) 883-5377

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070424000070 MT Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335244185 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25758MTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence St Joseph Medical Center CurrentSince Oct 18, 2009 Accepting new patients
Credena Health LLC CurrentSince Oct 18, 2009 Accepting new patients
Providence St Joseph Medical Center Current Accepting new patients

Locations

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

6 13th Ave E
Polson, MT 59860
Phone (406) 883-5377

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.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992860944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 13TH AVE E",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598605315",
            "telephone_number": "406-883-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 13TH AVE E",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598605315",
            "telephone_number": "406-883-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUND",
        "first_name": "BROOKE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MT",
            "license": "25758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Polson, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.