Individual provider Active NPI

Alison M Brady, PA-C

  • Physician Assistant
  • Gillette, WY
National Provider Identifier
1053697920
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
530 Issued in WY
Practice address
407 S Medical Arts CT Ste D
Gillette, WY 82716-3372
Phone
(307) 686-0308
Fax
(307) 686-7420
NPI assigned
Oct 24, 2011
Last updated
Jul 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 530 WY Primary

Addresses

Primary practice location

407 S Medical Arts CT Ste D
Gillette, WY 82716-3372

Mailing address

407 S Medical Arts CT Ste D
Gillette, WY 82716-3372
Phone (307) 686-0308

Other names 1

  • Alison Simpson Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20140311000396 WY Practitioner - Physician Assistant 8628208758 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
530WYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of Sheridan County CurrentSince Nov 1, 2014 Accepting new patients
Memorial Hospital of Sheridan County CurrentSince Nov 1, 2014 Accepting new patients
Peak Emergency Physicians LLC Past Accepting new patients

Locations

1401 W 5th St
Sheridan, WY 82801
Phone (307) 672-1000

Organizations & group practices 4

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": "1319414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1053697920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 S MEDICAL ARTS CT STE D",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163372",
            "telephone_number": "307-686-0308",
            "fax_number": "307-686-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S MEDICAL ARTS CT STE D",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163372",
            "telephone_number": "307-686-0308",
            "fax_number": "307-686-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "ALISON",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-24",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALISON",
            "last_name": "SIMPSON",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gillette, WY

Sources for this page

Verify at the official NPI Registry.