Individual provider Active NPI

Deanna N Brady, DNP, NPP-BC, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Clinton, NY
National Provider Identifier
1194992065
Registry record updated Mar 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
401548 Issued in NY
Practice address
3 Kirkland Ave Ste 202
Clinton, NY 13323-1462
Phone
(315) 853-2125
Fax
(315) 853-2125
NPI assigned
May 10, 2008
Last updated
Mar 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 335541 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 401548 NY Primary

Addresses

Primary practice location

3 Kirkland Ave Ste 202
Clinton, NY 13323-1462

Mailing address

3 Kirkland Ave Ste 202
Clinton, NY 13323-1462
Phone (315) 853-2125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210924000599 NY Order and Referring Only - Nurse Practitioner 8921176876

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
335541NYMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1210377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1194992065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 KIRKLAND AVE STE 202",
            "city": "CLINTON",
            "state": "NY",
            "postal_code": "133231462",
            "telephone_number": "315-853-2125",
            "fax_number": "315-853-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 KIRKLAND AVE STE 202",
            "city": "CLINTON",
            "state": "NY",
            "postal_code": "133231462",
            "telephone_number": "315-853-2125",
            "fax_number": "315-853-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "DEANNA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DNP, NPP-BC, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-10",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "335541",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NY

Sources for this page

Verify at the official NPI Registry.