Individual provider Active NPI

Brandy Renee Decourcey

  • Nurse's Aide
  • Dayton, OH
National Provider Identifier
1346545035
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
A02110 Issued in KY
Practice address
7625 Paragon Rd Ste C
Dayton, OH 45459-4063
Phone
(877) 480-6398
NPI assigned
Jan 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X A02110 KY Primary

Addresses

Primary practice location

7625 Paragon Rd Ste C
Dayton, OH 45459-4063

Mailing address

8404 Ponderosa RDG
Ashland, KY 41102-9034
Phone (606) 369-6334

Other names 1

  • Brandy Renee Bradley Former name

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
A02110KYMDNurse's Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Next Medical Staffing Past 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": "1294704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1346545035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8404 PONDEROSA RDG",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411029034",
            "telephone_number": "606-369-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7625 PARAGON RD STE C",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594063",
            "telephone_number": "877-480-6398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECOURCEY",
        "first_name": "BRANDY",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-11",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "KY",
            "license": "A02110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "BRADLEY",
            "middle_name": "RENEE",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.