Active NPI
Breon Latonia Merrett, HOME HEALTH
- Home Health Aide
- Des Moines, IA
National Provider Identifier
1598397564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 3920 Beaver Ave
Des Moines, IA 50310-3635 - Phone
- (515) 803-4041
- Fax
- (515) 279-0920
- NPI assigned
- Feb 7, 2020
- Last updated
- Feb 7, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | IA | Primary |
Addresses
Primary practice location
3920 Beaver Ave
Des Moines, IA 50310-3635
Mailing address
3920 Beaver Ave
Des Moines, IA 50310-3635
Phone (515) 803-4041
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1211 | Medicaid | IA |
Other names 1
- Breon Latonia Merrettcook
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | sallybllc@gmail.com | Health Information Exchange (HIE) |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581033600000",
"number": "1598397564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3920 BEAVER AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503103635",
"telephone_number": "515-803-4041",
"fax_number": "515-279-0920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3920 BEAVER AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503103635",
"telephone_number": "515-803-4041",
"fax_number": "515-279-0920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRETT",
"first_name": "BREON",
"middle_name": "LATONIA",
"credential": "HOME HEALTH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-07",
"last_updated": "2020-02-07",
"certification_date": "2020-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "IA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1211",
"state": "IA"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "sallybllc@gmail.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"contentOtherDescription": "sally b home health",
"address_1": "3920 Beaver Ave",
"city": "Des Moines",
"state": "IA",
"country_code": "US",
"postal_code": "503103635",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "BREON",
"last_name": "MERRETTCOOK",
"middle_name": "LATONIA",
"credential": "CMA",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.