NPIMap

Individual provider Active NPI

Allen Bracebridge, APRN, FNP-C

  • Family Nurse Practitioner
  • Crescent City, CA
National Provider Identifier
1790441871
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11015363 Issued in FL
Practice address
515 E Washington Blvd
Crescent City, CA 95531-8342
Phone
(707) 460-1802
NPI assigned
Nov 12, 2021
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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 APRN11015363 FL Primary

Addresses

Primary practice location

515 E Washington Blvd
Crescent City, CA 95531-8342

Mailing address

501 N Orlando Ave Ste 313
#163
Winter Park, FL 32789-7310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260130001804 CA Practitioner - Nurse Practitioner 1557756046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stallant Medical Group IncGroup PAC ID 6406283845, 17 clinicians

Practice addresses (Care Compare)

515 E Washington Blvd
Crescent City, CA 95531-8342
Phone (707) 460-1802

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stallant Medical Group Inc CurrentSince Dec 13, 2025 Accepting new patients
Stallant Medical Group Inc CurrentSince Dec 13, 2025 Accepting new patients

Locations

515 E Washington Blvd
Crescent City, CA 95531
Phone (707) 460-1802

Interoperability endpoints

  • Direct secure messaging: allen.bracebridge.1@33456.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1790441871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N ORLANDO AVE STE 313",
            "address_2": "#163",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327897310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E WASHINGTON BLVD",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318342",
            "telephone_number": "707-460-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACEBRIDGE",
        "first_name": "ALLEN",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-12",
        "last_updated": "2025-09-11",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11015363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crescent City, CA

Sources for this page

Verify at the official NPI Registry.