Individual provider Active NPI

Brianna Childress, DNP

  • Nurse Practitioner
  • Portage, MI
National Provider Identifier
1972308146
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704354124 Issued in MI
Practice address
3770 Glenkerry CT
Portage, MI 49024-0700
Phone
(269) 431-4007
NPI assigned
Feb 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704354124 MI Primary

Addresses

Primary practice location

3770 Glenkerry CT
Portage, MI 49024-0700

Mailing address

201 Cherry Hill St
Kalamazoo, MI 49006-4220
Phone (517) 320-1607

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
I20250707001276 MI Practitioner - Nurse Practitioner 4385168723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Michigan Pain Consultants PCGroup PAC ID 3173590957, 11 clinicians

Practice addresses (Care Compare)

3770 Glenkerry CT
Portage, MI 49024-0700
Phone (269) 329-2887

Hospital & facility affiliations

  • Oaklawn Hospital Hospital, Marshall, MI, CCN 230217
  • Bronson Battle Creek Hospital Hospital, Battle Creek, MI, CCN 230075
  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
  • Borgess Medical Center Hospital, Kalamazoo, MI, CCN 230117
  • Three Rivers Health Hospital, Three Rivers, MI, CCN 230015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704354124MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Michigan Pain Consultants PC CurrentSince Jun 13, 2025 Accepting new patients
Royal Universal Adult Care PastSince Nov 12, 2020 Accepting new patients
Michigan Behavioral Consultants PC PastSince Jun 13, 2025 Accepting new patients

Locations

4121 Shrestha Dr
Bay City, MI 48706
Phone (989) 460-0020

1525 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 363-0055

105 Winston Dr
Marshall, MI 49068
Phone (269) 781-3561

3770 Glenkerry Ct
Portage, MI 49024
Phone (269) 329-2887

3950 Hollywood Rd
Ste 260
Saint Joseph, MI 49085
Phone (269) 429-3865

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1739404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1972308146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 CHERRY HILL ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490064220",
            "telephone_number": "517-320-1607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3770 GLENKERRY CT",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490240700",
            "telephone_number": "269-431-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDRESS",
        "first_name": "BRIANNA",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-13",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704354124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.