Organization Active NPI

Julia Brannon PHD & Associates Incorporated

  • Clinical Psychologist
  • Reidsville, NC
National Provider Identifier
1003899634
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1396 Issued in NC
Legal business name
JULIA BRANNON PHD & ASSOCIATES INCORPORATED
Practice address
546 Sandy Cross Rd
Reidsville, NC 27320-5571
Phone
(336) 951-0000
Fax
(336) 951-0002
NPI assigned
Nov 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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

Authorized official

Name
Dr. Julia M Brannon, PHDNPI 1073795514
Title
Owner
Phone
(336) 349-5553

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 1396 NC Primary

Addresses

Primary practice location

546 Sandy Cross Rd
Reidsville, NC 27320-5571

Mailing address

546 Sandy Cross Rd
Reidsville, NC 27320-5571
Phone (336) 951-0000

Other identifiers 1

IdentifierTypeStateIssuer
6000093MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080519000693 NC Part B Supplier - Clinic/Group Practice 1658399746 Receives reassigned benefits from 1 practitioner
Practice locations: Winston Salem, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392076800000",
    "number": "1003899634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 SANDY CROSS RD",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205571",
            "telephone_number": "336-951-0000",
            "fax_number": "336-951-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 SANDY CROSS RD",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205571",
            "telephone_number": "336-951-0000",
            "fax_number": "336-951-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIA BRANNON PHD & ASSOCIATES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2014-02-11",
        "status": "A",
        "authorized_official_last_name": "BRANNON",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-349-5553",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "1396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000093",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reidsville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.