Active NPI
Brent Lawrence Guard
- Counselor
- Kodiak, AK
National Provider Identifier
1700370202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 18-135-BHA1
- Practice address
- 3449 E Rezanof Dr
Kodiak, AK 99615-6952 - Phone
- (907) 486-1386
- Fax
- (907) 847-2264
- NPI assigned
- Jun 18, 2018
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 18-135-BHA1 | AK | Primary |
Addresses
Primary practice location
3449 E Rezanof Dr
Kodiak, AK 99615-6952
Mailing address
PO Box 127
Larsen Bay, AK 99624-0127
Phone (907) 486-1386
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18-135-BHA1 | AK | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529280000000",
"number": "1700370202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 127",
"city": "LARSEN BAY",
"state": "AK",
"postal_code": "996240127",
"telephone_number": "907-486-1386",
"fax_number": "907-847-2264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3449 E REZANOF DR",
"city": "KODIAK",
"state": "AK",
"postal_code": "996156952",
"telephone_number": "907-486-1386",
"fax_number": "907-847-2264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUARD",
"first_name": "BRENT",
"middle_name": "LAWRENCE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-18",
"last_updated": "2018-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AK",
"license": "18-135-BHA1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kodiak, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.