Individual provider Active NPI

Sara Beth Brauninger, PHYSICIAN ASSISTANT

  • Surgical Physician Assistant
  • Memphis, TN
National Provider Identifier
1043850241
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4177 Issued in TN
Practice address
55 Humphreys Center Dr Ste 200
Memphis, TN 38120-2366
Phone
(901) 747-0040
NPI assigned
Jan 15, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4177 TN
Surgical Physician Assistant 363AS0400X 4177 TN Primary

Addresses

Primary practice location

55 Humphreys Center Dr Ste 200
Memphis, TN 38120-2366

Mailing address

55 Humphreys Center Dr Ste 200
Memphis, TN 38120-2366
Phone (901) 747-0040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4177TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Group, PC Surgical PastSince Jun 1, 2004 Accepting new patients
MSK Group PC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1043850241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 HUMPHREYS CENTER DR STE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202366",
            "telephone_number": "901-747-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HUMPHREYS CENTER DR STE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202366",
            "telephone_number": "901-747-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUNINGER",
        "first_name": "SARA",
        "middle_name": "BETH",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "4177",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "4177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.