BRINTON J FEGLEY (NPI# 1790759462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790759462 |
| Entity Type | Individual |
| Full Name | BRINTON J FEGLEY |
| Credential | NP |
| Practice Address |
2727 Hearne Ave Shreveport LA 71103-3931 |
| Mailing Address |
Po Box 37388 Shreveport LA 71133-7388 |
| Practice Telephone | 3186316400 |
| Practice Fax Number | 3186310300 |
| Mailing Telephone | 3186316400 |
| Mailing Fax Number | 3186310300 |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2016-09-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
AP04104 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1160016 | 05 |
| Street Address |
2727 HEARNE AVE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-3931 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255321881 | Michael Glen Walton | Internal Medicine | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3917 | 2005-10-25 |
| 1972043511 | Wk Heart and Vascular Institute Chf Clinic | Internal Medicine | 2727 Hearne Ave, Shreveport, LA 71103-3917 | 2017-03-01 |
| 1831633510 | Kerri Lavigne | Physician Assistant | 2727 Hearne Ave, 300, Shreveport, LA 71103-3917 | 2016-12-14 |
| 1063963890 | Alex Stewart | Nurse Practitioner | 2727 Hearne Ave, Ste 300, Shreveport, LA 71103-3917 | 2016-10-17 |
| 1710366570 | James Clay Harris | Nurse Practitioner | 2727 Hearne Ave, Suite 301, Shreveport, LA 71103-3917 | 2015-05-27 |
| 1487914453 | Amy Myers Brainis | Nurse Practitioner | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3917 | 2012-05-23 |
| 1871877407 | Cassie James Miller | Physician Assistant | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3917 | 2011-09-30 |
| 1952610883 | Shannon Lea Betzing | Physician Assistant | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3931 | 2010-09-27 |
| 1134457757 | Kelli Marie Neal | Physician Assistant | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3931 | 2009-11-19 |
| 1306173638 | Amanda Mariah Savoie | Physician Assistant | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3931 | 2009-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
| 1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
| 1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
| 1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
| 1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
| 1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
| 1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
| 1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
| Find all providers in zip 71103 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293355 | Sheronica V Simmons | Nurse Practitioner | 2751 Albert L Bicknell Dr Ste 3c, Shreveport, LA 71103-3943 | 2020-10-25 |
| 1316410236 | Tanya Nicole Slayter | Nurse Practitioner | 1811 E Bert Koun Loop Ste 210, Shreveport, LA 71105-5740 | 2019-01-03 |
| 1679061279 | Antonya Williams | Nurse Practitioner | 9419 Amity Way, Shreveport, LA 71118-3601 | 2018-04-29 |
| 1922475227 | Dillon Hart Acnp, LLC | Nurse Practitioner | 5021 Beechwood Hills Dr, Shreveport, LA 71107-9175 | 2015-08-22 |
| 1487066296 | Alfred W. Hathorn Jr., M.d. Apmc | Nurse Practitioner | 2120 Bert Koun Loop, Suite # L, Shreveport, LA 71118-3351 | 2014-05-28 |
| 1427675701 | Lakyn Paige Smith | Nurse Practitioner | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2020-07-02 |
| 1700401908 | Amanda Marie Davis | Nurse Practitioner | 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 | 2020-06-12 |
| 1437774635 | April Chase | Nurse Practitioner | 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 | 2020-06-12 |
| 1215560578 | Benjamin Potter | Nurse Practitioner | 1800 Irving Pl, Shreveport, LA 71101-4608 | 2020-02-14 |
| 1922653443 | Tarcariyunn Shantay Caldwell | Nurse Practitioner | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2019-08-02 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71103 |
Please comment or provide details below to improve the information on BRINTON J FEGLEY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.