Individual provider Active NPI

Brent M Pippins, AGNP-C

  • Registered Nurse
  • Monroe, LA
National Provider Identifier
1770140642
Registry record updated May 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN147407 Issued in LA
Practice address
3200 Sterlington Rd Apt 211
Monroe, LA 71203-2681
Phone
(318) 355-0692
NPI assigned
May 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN147407 LA Primary

Addresses

Primary practice location

3200 Sterlington Rd Apt 211
Monroe, LA 71203-2681

Mailing address

3200 Sterlington Rd Apt 211
Monroe, LA 71203-2681
Phone (318) 355-0692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20210922003408 LA Practitioner - Nurse Practitioner 8224435912 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN147407LAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Association of Northeast Louisiana Inc. CurrentSince May 21, 2021 Accepting new patients

Locations

102 Thomas Rd
Ste 103
West Monroe, LA 71291
Phone (318) 387-1946

Interoperability endpoints

  • Direct secure messaging: bpippins77325@direct.casso.us.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1558742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558742400000",
    "number": "1770140642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 STERLINGTON RD APT 211",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712032681",
            "telephone_number": "318-355-0692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 STERLINGTON RD APT 211",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712032681",
            "telephone_number": "318-355-0692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIPPINS",
        "first_name": "BRENT",
        "middle_name": "M",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-25",
        "last_updated": "2019-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN147407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.