Individual provider Active NPI

Lanessa Renee Brant, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Latham, NY
National Provider Identifier
1649852450
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024181259 Issued in VA
Practice address
38A Old Sparrowbush Rd
Latham, NY 12110-2927
Phone
(315) 469-8700
NPI assigned
Apr 22, 2021
Last updated
Aug 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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 0024181259 VA Primary

Addresses

Primary practice location

38A Old Sparrowbush Rd
Latham, NY 12110-2927

Mailing address

3152 Sybilla St
Chesapeake, VA 23323-1413
Phone (757) 969-2965

Other practice location 1

515 Newtown Rd
Virginia Beach, VA 23462-5620
Phone (757) 499-7526

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
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cny Fertility Center Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1649852450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3152 SYBILLA ST",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233231413",
            "telephone_number": "757-969-2965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38A OLD SPARROWBUSH RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102927",
            "telephone_number": "315-469-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 Newtown Rd",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234625620",
            "country_code": "US",
            "telephone_number": "757-499-7526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANT",
        "first_name": "LANESSA",
        "middle_name": "RENEE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2022-08-01",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024181259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.