Individual provider Active NPI

Anthony Louis Brandon, ETC

  • Non-emergency Medical Transport (VAN)
  • Saint Louis, MO
National Provider Identifier
1588834683
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Practice address
323 E Clinton PL
Saint Louis, MO 63122-6455
Phone
(314) 565-0560
Fax
(314) 822-4612
NPI assigned
Mar 4, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X MO Primary

Addresses

Primary practice location

323 E Clinton PL
Saint Louis, MO 63122-6455

Mailing address

323 E Clinton PL
Saint Louis, MO 63122-6455
Phone (314) 565-0560

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
343900000XMOMDNon-emergency Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1588834683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 E CLINTON PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631226455",
            "telephone_number": "314-565-0560",
            "fax_number": "314-822-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 E CLINTON PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631226455",
            "telephone_number": "314-565-0560",
            "fax_number": "314-822-4612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "ANTHONY",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "ETC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.