Active NPI
Kevin L Brink, M.D.
- Anesthesiology Physician
- Arcata, CA
National Provider Identifier
1619083722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G59216
- Practice address
- 3800 Janes Rd
Arcata, CA 95521-4742 - Phone
- (707) 442-4848
- NPI assigned
- Aug 22, 2006
- Last updated
- Aug 27, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G59216 | CA | Primary |
Addresses
Primary practice location
3800 Janes Rd
Arcata, CA 95521-4742
Mailing address
PO Box 3669
Santa Rosa, CA 95402-3669
Phone (707) 535-4300
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59216 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409097600000",
"number": "1619083722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3669",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954023669",
"telephone_number": "707-535-4300",
"fax_number": "707-535-4311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 JANES RD",
"city": "ARCATA",
"state": "CA",
"postal_code": "955214742",
"telephone_number": "707-442-4848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRINK",
"first_name": "KEVIN",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2014-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G59216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arcata, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.