Branson Pulmonology LLC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

2005015440 Issued in MO

Legal business name

BRANSON PULMONOLOGY LLC

Doing business as

Tri Lakes Pulmonology

Practice address

545 Branson Landing Blvd Ste 301
Branson, MO 65616-4055

Phone

(417) 230-8070

Fax

(417) 336-1280

NPI assigned

Sep 5, 2007

Last updated

May 29, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mohamed Bakry, M.D.

Title

Physician

Phone

(417) 230-8070

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Tri Lakes Pulmonology Doing business as

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1023202736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 BRANSON LANDING BLVD STE 301",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656164055",
            "telephone_number": "417-230-8070",
            "fax_number": "417-336-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 BRANSON LANDING BLVD STE 301",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656164055",
            "telephone_number": "417-230-8070",
            "fax_number": "417-336-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANSON PULMONOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-05",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "BAKRY",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "417-230-8070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MO",
            "license": "2005015440",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "2005015440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507601300",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000015456",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri Lakes Pulmonology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Branson Nephrology LLC
• Branson Oncology Clinic, L.L.C.
• Branson Pediatric Dental LLC
• Branson Psychological & Diagnostic Services PC
• Branson Pulmonology and Sleep LLC
• Branson School Dist R-4
• Layna Marie Brantner, PMHNP-BC
• James T Brawner, M.D.
• Ami Rachelle Bremer
• Kaci Bremer, PHARM.D.

• Pulmonary Disease Physician in Branson, MO
• Providers in Branson, MO by specialty
• Pulmonary Disease Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.