Brandyn J McComb

Key facts

NPI

1497528384

Entity type

Individual (NPI type 1)

Primary specialty

Ambulatory Care Registered Nurse 163WP2201X

License

RN316531 (GA)

Practice address

3027 Bannack LN
Harlem, GA 30814-5148

Phone

(517) 582-1000

NPI assigned

Nov 1, 2023

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 1, 2023.

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1497528384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3027 BANNACK LN",
            "city": "HARLEM",
            "state": "GA",
            "postal_code": "308145148",
            "telephone_number": "517-582-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3027 BANNACK LN",
            "city": "HARLEM",
            "state": "GA",
            "postal_code": "308145148",
            "telephone_number": "517-582-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOMB",
        "first_name": "BRANDYN",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-01",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "GA",
            "license": "RN316531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Harlem, GA · Ambulatory Care Registered Nurse in Georgia