Individual provider Active NPI

Brian Joseph Allar, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • White Lake, MI
National Provider Identifier
1841813813
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704308354 Issued in MI
Practice address
1738 Ridge Rd
White Lake, MI 48383-1784
Phone
(248) 459-5253
NPI assigned
May 25, 2020
Last updated
Jul 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704308354 MI Primary
Registered Nurse 163W00000X 4704308354 MI

Addresses

Primary practice location

1738 Ridge Rd
White Lake, MI 48383-1784

Mailing address

1738 Ridge Rd
White Lake, MI 48383-1784
Phone (248) 459-5253

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
I20200717001603 MI Practitioner - Nurse Practitioner 3072937465 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704308354MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
SJMH Medical Practice-SMHC CurrentSince Nov 7, 2024 Accepting new patients
SJMH Medical Practice-SMHC CurrentSince Nov 7, 2024 Accepting new patients

Locations

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

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.

NPI Registry JSON

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

{
    "created_epoch": "1590364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1841813813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1738 RIDGE RD",
            "city": "WHITE LAKE",
            "state": "MI",
            "postal_code": "483831784",
            "telephone_number": "248-459-5253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1738 RIDGE RD",
            "city": "WHITE LAKE",
            "state": "MI",
            "postal_code": "483831784",
            "telephone_number": "248-459-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLAR",
        "first_name": "BRIAN",
        "middle_name": "JOSEPH",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-25",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704308354",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704308354",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Lake, MI

Sources for this page

Verify at the official NPI Registry.