Individual provider Active NPI

Shirron E Brisseau

  • Home Health Aide
  • Suffolk, VA
National Provider Identifier
1801386206
Registry record updated May 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
346 N. Main St
Suffolk, VA 23434
Phone
(757) 350-4477
Fax
(757) 350-4488
NPI assigned
May 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Primary

Addresses

Primary practice location

346 N. Main St
Suffolk, VA 23434

Mailing address

346 N Main St
Suffolk, VA 23434-4447
Phone (757) 350-4477

Other identifiers 1

IdentifierTypeStateIssuer
1669865291MedicaidVA

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

NPI Registry JSON

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525996800000",
    "number": "1801386206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 N MAIN ST",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344447",
            "telephone_number": "757-350-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 N. MAIN ST",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "23434",
            "telephone_number": "757-350-4477",
            "fax_number": "757-350-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISSEAU",
        "first_name": "SHIRRON",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-11",
        "last_updated": "2018-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669865291",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.

Verify at the official NPI Registry.