Brandalon Marie Fly, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

33359 Issued in TN

Practice address

240 New Byhalia Rd
Collierville, TN 38017-3716

Phone

(901) 492-4920

NPI assigned

Feb 10, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

81.87 of 100Reported as group

Quality

64.75

Promoting interoperability

100

Improvement activities

40

Cost

74.81

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brandalon.fly@krogerhealth.eclinicaldirectplus.com

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.

• The Little Clinic of Tennessee LLC

  • Family Nurse Practitioner
  • White House, TN
  • NPI 1487848800
  Medicare reassignment NPD
• Baptist Memorial Medical Group Inc

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1306089206
  Medicare reassignment

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1023715968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 COTTON GIN RD",
            "city": "ROSSVILLE",
            "state": "TN",
            "postal_code": "380665028",
            "telephone_number": "731-618-9634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 NEW BYHALIA RD",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380173716",
            "telephone_number": "901-492-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLY",
        "first_name": "BRANDALON",
        "middle_name": "MARIE",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-10",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905911",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "33359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Choice Urgent Care LLC
• First Choice Wellness PLLC
• Zekeria Fleming
• Jennifer Flores
• Amber Floyd-Wehrenberg
• Tina Fly
• FMSC Collierville Operating Company
• FMSC Collierville Operating Company LLC
• Erin Michelle Fontana, PTA
• Ira Dean Fontenot, P.D.

• Family Nurse Practitioner in Collierville, TN
• Providers in Collierville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.