Brehon Charles Allen Jr., NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A135733 Issued in IA

Practice address

2979 Victoria St
Bettendorf, IA 52722-2784

Phone

(563) 332-8528

Fax

(563) 332-9331

NPI assigned

Apr 3, 2007

Last updated

Aug 25, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1861513046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2979 VICTORIA ST",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527222784",
            "telephone_number": "563-332-8528",
            "fax_number": "563-332-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2979 VICTORIA ST",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527222784",
            "telephone_number": "563-332-8528",
            "fax_number": "563-332-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "BREHON",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A135733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eric John Allen, PT, SCS, ATC
• Erin Marie Allen, MS
• Nicole Brooke Allen, ARNP
• Carl John Alm, ARNP
• Amanda J Alongi, NP

• Family Nurse Practitioner in Bettendorf, IA
• Providers in Bettendorf, IA by specialty
• Family Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.