Active NPI
Brandon Flaig, RN
- Student in an Organized Health Care Education/Training Program
- Pomona, CA
National Provider Identifier
1306443379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 309 E 2ND St
Pomona, CA 91766-1854 - Phone
- (909) 469-5589
- NPI assigned
- Oct 2, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 95142111 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
309 E 2ND St
Pomona, CA 91766-1854
Mailing address
309 E 2ND St
Pomona, CA 91766-1854
Phone (909) 469-5589
Other practice location 1
10535 Hospital Way
Mather, CA 95655-4200
Phone (916) 843-7000
Other practice location 2
5318 Manzanita Ave
Carmichael, CA 95608-0512
Phone (916) 331-8513
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251121003921 | CA | Order and Referring Only - Family Practice | 7810489317 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4657 | CA | MD | Marriage & Family Therapist |
| 95142111 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684108800000",
"number": "1306443379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 E 2ND ST",
"city": "POMONA",
"state": "CA",
"postal_code": "917661854",
"telephone_number": "909-469-5589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 E 2ND ST",
"city": "POMONA",
"state": "CA",
"postal_code": "917661854",
"telephone_number": "909-469-5589"
}
],
"practiceLocations": [
{
"address_1": "10535 Hospital Way",
"address_purpose": "LOCATION",
"city": "Mather",
"state": "CA",
"postal_code": "956554200",
"country_code": "US",
"telephone_number": "916-843-7000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5318 Manzanita Ave",
"address_purpose": "LOCATION",
"city": "Carmichael",
"state": "CA",
"postal_code": "956080512",
"country_code": "US",
"telephone_number": "916-331-8513",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FLAIG",
"first_name": "BRANDON",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-02",
"last_updated": "2023-05-15",
"certification_date": "2023-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "95142111",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.