Individual provider Active NPI

Malena Lauren Brissett, LPN

  • Licensed Practical Nurse
  • Columbus, GA
National Provider Identifier
1245960970
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN100663 Issued in GA
Practice address
2100 Comer Ave
Columbus, GA 31904-8725
Phone
(706) 596-5500
NPI assigned
Jun 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN100663 GA Primary

Addresses

Primary practice location

2100 Comer Ave
Columbus, GA 31904-8725

Mailing address

5253 Crystal CT Apt D
Columbus, GA 31907-8007
Phone (678) 756-1703

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

State licenses

LicenseStateTypeSpecialty
LPN100663GAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1245960970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5253 CRYSTAL CT APT D",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319078007",
            "telephone_number": "678-756-1703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 COMER AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319048725",
            "telephone_number": "706-596-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISSETT",
        "first_name": "MALENA",
        "middle_name": "LAUREN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN100663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.