Alisha Breanna Jain, PMHNP-BC; APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2018001757 Issued in MO

Practice address

3600 S National Ave
Springfield, MO 65807-7311

Phone

(417) 322-6622

Fax

(417) 350-1935

NPI assigned

Jan 11, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Alisha Breanna Dean Former name

Medicare fee-for-service enrollment

Enrolled in MO, AR2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Honour Brite LLCGroup PAC ID 3971864588, 14 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.1 of 100Reported as group

Quality

82.5

Promoting interoperability

100

Improvement activities

40

Cost

81.16

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alisha.jain.1@21190.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Honour Brite LLC

  dba Eustasis Psychiatric and Addiction Health

  • Multi-Specialty Clinic/Center
  • Springfield, MO
  • NPI 1548760820

  AR, Family Medicine

  Medicare reassignment Care Compare group NPD
• Eustasis Foundation, Inc

  • Voluntary or Charitable Agency
  • Springfield, MO
  • NPI 1386257780
  NPD (past) Authorized official

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1942718978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077311",
            "telephone_number": "417-322-6622",
            "fax_number": "417-350-1935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 S Promenade Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727588609",
            "country_code": "US",
            "telephone_number": "479-427-7722",
            "fax_number": "479-427-7721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5548 N Farmer Branch Rd",
            "address_purpose": "LOCATION",
            "city": "Ozark",
            "state": "MO",
            "postal_code": "657215315",
            "country_code": "US",
            "telephone_number": "417-322-6622",
            "fax_number": "417-350-1935",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1505 E Bradford Pkwy",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658046566",
            "country_code": "US",
            "telephone_number": "417-322-6622",
            "fax_number": "417-350-1935",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2005 W Elm St",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727584018",
            "country_code": "US",
            "telephone_number": "479-427-7722",
            "fax_number": "479-427-7721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAIN",
        "first_name": "ALISHA",
        "middle_name": "BREANNA",
        "credential": "PMHNP-BC; APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-11",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2018001757",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "213500",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2018001757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259139758",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420050654",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALISHA",
            "last_name": "DEAN",
            "middle_name": "BREANNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gary Brett Jacques, MS, PLPC
• Wayne L Jaeger, CRNA
• Mostafa Jafari, MD
• Amit Jagtiani, MD
• Alexandra Jahnke, ATC
• Alok Jain, MD
• Essra Jameel, DDS
• Jerard Jamena, PHARM.D.
• James M. Carmichael, DC PC
• James R. Cook, MD

• Psychiatric/Mental Health Nurse Practitioner in Springfield, MO
• Providers in Springfield, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.