Active NPI
Alyssa Nicole Brimhall, PA-C
- Physician Assistant
- St Cloud, MN
National Provider Identifier
1639468671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10881
- Practice address
- 1200 Sixth Ave N
Centracare Clinic
St Cloud, MN 56303-2735 - Phone
- (320) 252-5131
- NPI assigned
- Mar 30, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10881 | MN | Primary |
Addresses
Primary practice location
1200 Sixth Ave N
Centracare Clinic
St Cloud, MN 56303-2735
Mailing address
1200 Sixth Ave N
Centracare Clinic
St Cloud, MN 56303-2735
Phone (320) 252-5131
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10881 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centracare Clinic | Past | Accepting new patients | |
| Centracare Clinic | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- St Joseph, MN
- NPI 1134121759
-
- Multi-Specialty Clinic/Center
- Saint Cloud, MN
- NPI 1225030844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355184000000",
"number": "1639468671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 SIXTH AVE N",
"address_2": "CENTRACARE CLINIC",
"city": "ST CLOUD",
"state": "MN",
"postal_code": "563032735",
"telephone_number": "320-252-5131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 SIXTH AVE N",
"address_2": "CENTRACARE CLINIC",
"city": "ST CLOUD",
"state": "MN",
"postal_code": "563032735",
"telephone_number": "320-252-5131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIMHALL",
"first_name": "ALYSSA",
"middle_name": "NICOLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-30",
"last_updated": "2012-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "10881",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.