Brett Alexander Talley, PA-S

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1819 Carew St
Fort Wayne, IN 46805-4705

Phone

(260) 702-8055

NPI assigned

Aug 17, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1104438662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 BAYVIEW DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154203",
            "telephone_number": "616-848-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 CAREW ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054705",
            "telephone_number": "260-702-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLEY",
        "first_name": "BRETT",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-17",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "batalley18@my.trine.edu",
            "affiliation": "Y",
            "endpointDescription": "School/Professional Email Address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Physician Assistant Program",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Physician Assistant Program",
            "address_1": "1819 Carew St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jordan Tait, DPT
• Kristin M Tait, MSHS, PA-C
• Hassan Taki, M.D.
• Percy Boman Talati, RPT
• Torrey Talifer
• Christopher Philip Tallo, M.D.
• M Teresa Tallon, MD
• Tamara N Lombard, PHD, LLC
• Chung Ning Tan, MD
• Alexandru Bogdan Tanase, M.D.

• Student in an Organized Health Care Education/Training Program in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Student in an Organized Health Care Education/Training Program in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.