Individual provider Active NPI

Brian McDermott, FNP-C

  • Family Nurse Practitioner
  • Flint, MI
National Provider Identifier
1710454111
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704299849 Issued in MI
Practice address
1230 S Linden Rd Ste 4
Flint, MI 48532-3424
Phone
(810) 732-7077
NPI assigned
Oct 24, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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 4704299849 MI Primary

Addresses

Primary practice location

1230 S Linden Rd Ste 4
Flint, MI 48532-3424

Mailing address

PO Box 281
Fenton, MI 48430-0281
Phone (810) 348-2199

Other practice location 1

16310 Silver Landings
Fenton, MI 48430-9184
Phone (810) 348-2199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20181215000306 MI Practitioner - Nurse Practitioner 4880939057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Michigan Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mid-Michigan Pain Management Center PLCGroup PAC ID 0446312409, 2 clinicians

Practice addresses (Care Compare)

1230 S Linden Rd
Suite 4
Flint, MI 48532-3424
Phone (810) 732-7077

Hospital & facility affiliations

  • A Z Home Health Care Home health agency, Flint, MI, CCN 237695

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthland P C CurrentSince Jan 1, 2022 Accepting new patients
Mid-Michigan Pain Management Center, PLC CurrentSince Feb 25, 2019 Accepting new patients

Locations

1230 S Linden Rd
Ste 4
Flint, MI 48532
Phone (810) 732-7077

31700 Van Dyke Ave
Ste H
Warren, MI 48093
Phone (586) 445-2911

36433 Warren Rd
Westland, MI 48185
Phone (248) 247-6011

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.

Hospital & facility affiliations 1

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": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1710454111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 281",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484300281",
            "telephone_number": "810-348-2199",
            "fax_number": "810-309-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 S LINDEN RD STE 4",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323424",
            "telephone_number": "810-732-7077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16310 Silver Landings",
            "address_purpose": "LOCATION",
            "city": "Fenton",
            "state": "MI",
            "postal_code": "484309184",
            "country_code": "US",
            "telephone_number": "810-348-2199",
            "fax_number": "810-309-9828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "BRIAN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-24",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704299849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.