Individual provider Active NPI

Daysha A Brantley, MSN, FNP-C

  • Family Nurse Practitioner
  • Collinwood, TN
National Provider Identifier
1609978048
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12231 Issued in TN
Practice address
105 3Rd Ave N
Collinwood, TN 38450-4696
Phone
(931) 724-4628
Fax
(931) 724-4705
NPI assigned
Sep 5, 2006
Last updated
Apr 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12231 TN Primary

Addresses

Primary practice location

105 3Rd Ave N
Collinwood, TN 38450-4696

Mailing address

105 3Rd Ave N
Collinwood, TN 38450-4696
Phone (931) 724-4628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070215000395 TN Practitioner - Nurse Practitioner 7719989060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

105 3Rd Ave N
Collinwood, TN 38450-4696
Phone (931) 724-4628

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12231TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Collinwood Family Care, LLC Family CurrentSince May 18, 2020 Accepting new patients

Locations

105 3rd Ave N
Collinwood, TN 38450
Phone (931) 724-4628

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1609978048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 3RD AVE N",
            "city": "COLLINWOOD",
            "state": "TN",
            "postal_code": "384504696",
            "telephone_number": "931-724-4628",
            "fax_number": "931-724-4705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 3RD AVE N",
            "city": "COLLINWOOD",
            "state": "TN",
            "postal_code": "384504696",
            "telephone_number": "931-724-4628",
            "fax_number": "931-724-4705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANTLEY",
        "first_name": "DAYSHA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "12231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collinwood, TN

Sources for this page

Verify at the official NPI Registry.