Active NPI
Susan A Brannon, M.D.
- Multi-Specialty Clinic/Center
- Montgomery, AL
National Provider Identifier
1063548642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- License
- 14224
- Practice address
- 8160 Seaton PL
Montgomery, AL 36116-7204 - Phone
- (334) 272-1799
- Fax
- (334) 272-4876
- NPI assigned
- Feb 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | 14224 | AL | Primary |
Addresses
Primary practice location
8160 Seaton PL
Montgomery, AL 36116-7204
Mailing address
8160 Seaton PL
Montgomery, AL 36116-7204
Phone (334) 272-1799
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 631214880 | Other | AL | TAX ID |
| 000088077 | Medicaid | AL | |
| 051088077 | Other | AL | BCBS PROVIDER ID |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14224 | AL | MD | Multi-Specialty Clinic/Center |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Partners in Pediatrics LLC | Past | Accepting new patients | |
| Partners in Pediatrics, LLC | 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.
-
- Primary Care Clinic/Center
- Prattville, AL
- NPI 1063679496
-
- Primary Care Clinic/Center
- Montgomery, AL
- NPI 1528233103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411603200000",
"number": "1063548642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8160 SEATON PL",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361167204",
"telephone_number": "334-272-1799",
"fax_number": "334-272-4876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8160 SEATON PL",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361167204",
"telephone_number": "334-272-1799",
"fax_number": "334-272-4876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANNON",
"first_name": "SUSAN",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2014-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": "AL",
"license": "14224",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "631214880",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000088077",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER ID",
"identifier": "051088077",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.