Individual provider Active NPI

Nadiyah L Brandon, OT

Case Management Agency
Saint Louis, MO

National Provider Identifier

1053899153

Registry record updated May 20, 2021

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Organizations & group practices3
NPI Registry JSON
Other providers in Saint Louis, MO
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Case Management AgencyTaxonomy code 251B00000X
License: 3000688782 Issued in MO
Practice address: 1841 Arrow Point Dr
Saint Louis, MO 63138
Phone: (314) 708-9822
NPI assigned: Jul 31, 2018
Reactivated: May 12, 2020
Sex: Female
Sole proprietor: Yes

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 14

Specialty (taxonomy)	Code	License	State	Primary
Community Health Worker	172V00000X
Other Specialist/Technologist	246Z00000X
Nursing Care Agency	251J00000X	300688782	GA
In Home Supportive Care Agency	253Z00000X	3000688782	GA
Chore Provider	372500000X
Personal Care Attendant	3747P1801X
Home Health Aide	374U00000X
Case Manager/Care Coordinator	171M00000X	3000688782	GA
Case Manager/Care Coordinator	171M00000X
Case Manager/Care CoordinatorGroup: 193400000X SINGLE SPECIALTY GROUP	171M00000X	105389953	MO
Driver	172A00000X
Homemaker	376J00000X
Nurse's Aide	376K00000X
Case Management Agency	251B00000X	3000688782	MO	Primary

Addresses

Primary practice location

1841 Arrow Point Dr
Saint Louis, MO 63138

Mailing address

2847 Oldknow Dr NW
Atlanta, GA 30318
Phone (314) 371-7717

Other identifiers 5

Identifier	Type	State	Issuer
150249	Other	WA	SUPPLIER
NBRANDON35	Other	GA	ID
14645636	Other	MO	CAQH
DM3700	Medicaid	MO
PMOD10414	Other	MO	PUBLIC PARTNERSHIP

Electronic endpoints 6

Type	Endpoint	Use	Affiliation
FHIR URL	cms	Health Information Exchange (HIE)	Edu Health Pcs and Adc
CONNECT URL	cms	Health Information Exchange (HIE)	Edu Health Pcs and Adc
FHIR URL	emomed	Health Information Exchange (HIE)	Edu Health Pcs and Adc
RESTful URL	developer.availity.com	Direct
CONNECT URL	nadiyahb1984@outlook.com	Direct
Other URL	developer.avality.com/partner	Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Not enrolled

State licenses

License	State	Type	Specialty
3000688782	GA	MD	Case Manager/Care Coordinator
105389953	MO	MD	Case Manager/Care Coordinator
3000688782	MO	MD	Case Management Agency
300688782	GA	MD	Nursing Care Agency

Practice roles

Organization	Specialty	Status	New patients
Eduhealth Personal Care Services	Personal Care Attendant	CurrentSince Jun 6, 2021	Accepting new patients
Eduhealth Community Care	Case Manager/Care Coordinator	CurrentSince Jun 15, 2021	Accepting new patients
D&N Services Unlimited	Case Manager/Care Coordinator	CurrentSince Sep 8, 2019	Accepting new patients

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.

Eduhealth Personal Care Services
- Home Health Registered Nurse
- Saint Louis, MO
- NPI 1356984157
Personal Care Attendant
NPD Authorized official
Eduhealth Community Care
- Case Manager/Care Coordinator
- Atlanta, GA
- NPI 1538736806
NPD Authorized official
D&N Services Unlimited
- Case Management Agency
- Saint Louis, MO
- NPI 1386122497
Case Manager/Care Coordinator
NPD

NPI Registry JSON

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1053899153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2847 OLDKNOW DR NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30318",
            "telephone_number": "314-371-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 ARROW POINT DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63138",
            "telephone_number": "314-708-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "NADIYAH",
        "middle_name": "L",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "deactivation_date": "2019-10-18",
        "reactivation_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "300688782",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "3000688782",
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "GA",
            "license": "3000688782",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "MO",
            "license": "105389953",
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MO",
            "license": "3000688782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPPLIER",
            "identifier": "150249",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ID",
            "identifier": "NBRANDON35",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14645636",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DM3700",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PUBLIC PARTNERSHIP",
            "identifier": "PMOD10414",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "cms",
            "affiliation": "Y",
            "affiliationName": "Edu Health Pcs and Adc",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1841 Arrow Point Dr",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "63138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "cms",
            "affiliation": "Y",
            "affiliationName": "Edu Health Pcs and Adc",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1841 Arrow Point Dr",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "63138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "emomed",
            "affiliation": "Y",
            "affiliationName": "Edu Health Pcs and Adc",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1841 Arrow Point Dr",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "63138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "developer.availity.com",
            "affiliation": "N",
            "endpointDescription": "api",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2847 Oldknow Dr NW",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303187242",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "nadiyahb1984@outlook.com",
            "affiliation": "N",
            "endpointDescription": "messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "messages",
            "address_1": "2847 Oldknow Dr NW",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303187242",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "developer.avality.com/partner",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "production",
            "address_1": "2847 Oldknow Dr NW",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303187242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.