Individual provider Active NPI

Brinton J Fegley, NP

  • Acute Care Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1790759462
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP04104 Issued in LA
Practice address
2727 Hearne Ave
Shreveport, LA 71103-3931
Phone
(318) 631-6400
Fax
(318) 631-0300
NPI assigned
Feb 17, 2006
Last updated
Jun 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP04104 LA Primary

Addresses

Primary practice location

2727 Hearne Ave
Shreveport, LA 71103-3931

Mailing address

PO Box 37388
Shreveport, LA 71133-7388
Phone (318) 631-6400

Other identifiers 1

IdentifierTypeStateIssuer
1160016MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ Other

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
I20051010000255 LA Practitioner - Nurse Practitioner 9830114842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WKMC Cardiovascular ConsultantsGroup PAC ID 0941420061, 34 clinicians

Practice addresses (Care Compare)

2727 Hearne Ave
Suite 301
Shreveport, LA 71103-3918
Phone (318) 631-6400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.53 of 100Reported as apm
Quality
81.42
Promoting interoperability
94.6
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
WKMC Cardiovascular Consultants CurrentSince Sep 1, 2016 Accepting new patients
Pulmonary & Critical Care Specialists, L.L.C. Past Accepting new patients
WK Heart and Vascular Institute CHF Clinic Past Accepting new patients

Locations

2400 Hospital Dr
Ste 350
Bossier City, LA 71111
Phone (318) 212-7902

104 Morris Cir
Homer, LA 71040
Phone (318) 927-1110

102 S Monroe St
Minden, LA 71055
Phone (318) 377-3425

1029 Keyser Ave
Ste M
Natchitoches, LA 71457

1029 Keyser Ave
Ste N
Natchitoches, LA 71457
Phone (800) 256-1100

1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946

2727 Hearne Ave
Ste 301
Shreveport, LA 71103

8001 Youree Dr
Ste 740
Shreveport, LA 71115
Phone (318) 212-3830

10320 Little Patuxent Pkwy
Ste 23302
Columbia, MD 21044

Interoperability endpoints

  • Direct secure messaging: fegley_brint_np@yourcarecommunity.org

Organizations & group practices 3

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 9

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1790759462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37388",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711337388",
            "telephone_number": "318-631-6400",
            "fax_number": "318-631-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 HEARNE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033931",
            "telephone_number": "318-631-6400",
            "fax_number": "318-631-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEGLEY",
        "first_name": "BRINTON",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "AP04104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1160016",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.