Individual provider Active NPI

Christopher Chase Brazeal

  • Student in an Organized Health Care Education/Training Program
  • North Little Rock, AR
National Provider Identifier
1518719509
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3201 Springhill Dr
North Little Rock, AR 72117-2910
Phone
(501) 753-4232
NPI assigned
Apr 3, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3201 Springhill Dr
North Little Rock, AR 72117-2910

Mailing address

3201 Springhill Dr
North Little Rock, AR 72117-2910
Phone (501) 753-4232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240514003302 AR Order and Referring Only - Family PracticePractitioner - Family Practice 4486095007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1518719509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 SPRINGHILL DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172910",
            "telephone_number": "501-753-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 SPRINGHILL DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172910",
            "telephone_number": "501-753-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZEAL",
        "first_name": "CHRISTOPHER",
        "middle_name": "CHASE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "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 North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.