Individual provider Active NPI

Sabrina Kathlene Brackett

  • Medical Laboratory Technician
  • Old Fort, TN
National Provider Identifier
1104396431
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Laboratory TechnicianTaxonomy code 246RM2200X
Practice address
1498 Boanerges Church Rd
Old Fort, TN 37362-7028
Phone
(423) 457-0639
NPI assigned
Nov 29, 2018
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Laboratory Technician 246RM2200X TN Primary

Addresses

Primary practice location

1498 Boanerges Church Rd
Old Fort, TN 37362-7028

Mailing address

1498 Boanerges Church Rd
Old Fort, TN 37362-7028
Phone (423) 457-0639

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1104396431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1498 BOANERGES CHURCH RD",
            "city": "OLD FORT",
            "state": "TN",
            "postal_code": "373627028",
            "telephone_number": "423-457-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1498 BOANERGES CHURCH RD",
            "city": "OLD FORT",
            "state": "TN",
            "postal_code": "373627028",
            "telephone_number": "423-457-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKETT",
        "first_name": "SABRINA",
        "middle_name": "KATHLENE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-29",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RM2200X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Medical Laboratory",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Fort, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.