Individual provider Active NPI

Amy Elizabeth Brin, CNS-BC, CNL

  • Pediatric Clinical Nurse Specialist
  • Lexington, KY
National Provider Identifier
1114105558
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Clinical Nurse SpecialistTaxonomy code 364SP0200X
License
6260S Issued in KY
Practice address
2312 Alexandria Dr
Lexington, KY 40504-3229
Phone
(859) 276-5344
Fax
(859) 296-0362
NPI assigned
Feb 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Clinical Nurse Specialist 364SP0200X 6260S KY Primary

Addresses

Primary practice location

2312 Alexandria Dr
Lexington, KY 40504-3229

Mailing address

2312 Alexandria Dr
Lexington, KY 40504-3229
Phone (859) 276-5344

Other identifiers 1

IdentifierTypeStateIssuer
7100109860MedicaidKY

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Hospice Care, Inc. PastSince Apr 30, 2003 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338508800000",
    "number": "1114105558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2312 ALEXANDRIA DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043229",
            "telephone_number": "859-276-5344",
            "fax_number": "859-296-0362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 ALEXANDRIA DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043229",
            "telephone_number": "859-276-5344",
            "fax_number": "859-296-0362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIN",
        "first_name": "AMY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "CNS-BC, CNL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-07",
        "last_updated": "2012-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "KY",
            "license": "6260S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100109860",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; 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.